TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) DARLENE RODOWICZ...................................................................... PRESIDENT/TRUSTEE TERM BEGAN 1/1/22	25.00 ................. 25.00	X	X	0	605,131	46,484
(2) RICHARD ALCOMBRIGHT...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(3) THOMAS O ANDREWS...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(4) ALFRED A BARBALUNGA...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(5) ALEC R BELMAN MD...................................................................... TRUSTEE/PHYSICIAN TERM BEGAN 1/22	1.00 ................. 49.00	X		0	366,654	50,317
(6) JOHN L BISSELL...................................................................... TRUSTEE/VICE CHAIR	1.00 ................. 2.00	X	X	0	0	0
(7) BRONLY S BOYD...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(8) ALBERT BRAVO DPM...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(9) TIMOTHY BURKE...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(10) ROBERT P CELLA JR MD...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(11) EDITH KIT DOBELLE...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(12) DAVID HALL...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(13) LETICIA SEHAYNES...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(14) EDMUND HORNSTEIN DO...................................................................... TRUSTEE	1.00 ................. 2.00	X		192,314	0	0
(15) JAMES G KOLESAR...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(16) JOHN A LOIODUCE MD...................................................................... TRUSTEE/PHYSICIAN TERM BEGAN 1/22	1.00 ................. 49.00	X		0	0	0
(17) DAVID MORESI...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) BARTON D RASER........................................................................ TRUSTEE/CHAIR	1.00 .......................2.00	X	X			0	0	0
(19) CAROLE G SIEGEL........................................................................ TRUSTEE	1.00 .......................2.00	X				0	0	0
(20) ERWIN A STUEBNER JR MD........................................................................ TRUSTEE	1.00 .......................2.00	X				0	0	0
(21) ANAKATINA CORDON SUFFISH........................................................................ TRUSTEE/TERM BEGAN 08/22	1.00 .......................2.00	X				0	0	0
(22) JULIANNE BOYD........................................................................ TRUSTEE	1.00 .......................2.00	X				0	0	0
(23) JOSEPH C THOMPSON........................................................................ TRUSTEE/TERM ENDED 1/22	1.00 .......................2.00	X				0	0	0
(24) DAVID PHELPS........................................................................ TRUSTEE/PRESIDENT TERM ENDED 1/1/22	25.00 .......................25.00	X	X			0	1,137,632	51,452
(25) BRIAN BURKE MD........................................................................ TRUSTEE/PHYSICIAN TERM END 12/21	1.00 .......................49.00	X				0	197,521	36,053
(26) MICHAEL MCINERNEY MD........................................................................ TRUSTEE/PHYSICIAN TERM ENDED 12/21	1.00 .......................49.00	X				0	293,833	44,064
(27) SCOTT ST GEORGE........................................................................ TREASURER	37.00 .......................13.00		X			0	518,004	11,639
(28) CHERYL M BOUDREAU........................................................................ CLERK	19.00 .......................21.00		X			0	122,003	18,346
(29) MICHAEL MCHUGH MD........................................................................ CHAIRMAN-E.D. MEDICINE	50.00 .......................0.00			X		502,455	0	46,729
(30) ANDREW MANZER........................................................................ CHIEF OPERATING OFFICE	50.00 .......................0.00			X		502,575	0	42,827
(31) TONY MAKDISI MD........................................................................ HOSPITALIST	50.00 .......................0.00				X	591,444	0	45,474
(32) ROBIN BURNS-LAMBERT MD........................................................................ ANESTHESIOLOGIST	50.00 .......................0.00				X	567,757	0	45,299
(33) RAYMOND GARY SOHL MD........................................................................ ANESTHESIOLOGIST	50.00 .......................0.00				X	543,532	0	45,768
(34) SEETHA MUTHAVARAPU MD........................................................................ HOSPITALIST	50.00 .......................0.00				X	515,914	0	45,783
(35) BARANI MAYIL VAGANAN MD........................................................................ GASTROENTEROLOGIST	50.00 .......................0.00				X	513,708	0	39,700

(A) Name and business address	(B) Description of services	(C) Compensation
SHIELDS PHARMACY OF THE BERKSHIRE PO BOX 844023 BOSTON,MA022844023	PHARMACY CONSULTANT	5,603,087
FASTAFF LLC PO BOX 911452 DENVER,CO802911452	CONTRACTED LABOR	2,806,897
MEDTIGO STAFFING LLC PO BOX 397 DOVER,MA02030	CONTRACTED LABOR	2,784,600
QUEST DIAGNOSTICS PO BOX 844226 BOSTON,MA022844226	CONTRACTED LABOR	2,609,133
AHSA PO BOX 670529 DALLAS,TX752670529	CONTRACTED LABOR	1,468,931
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 34

- TIN:

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

BERKSHIRE MEDICAL CENTER INC

Employer identification number

04-2791396

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

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

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

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

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

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

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

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

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

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990) 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)		(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)		(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

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

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

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 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)		(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)		(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.)..

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

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990) 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

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer 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).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

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

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

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).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined 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.

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.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

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

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.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in 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.

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2021

Page 6

Part V

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

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

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

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

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

Schedule A (Form 990) 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:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2021

Name of the organization

BERKSHIRE MEDICAL CENTER INC

Employer identification number

04-2791396

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

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

Special Rules

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

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

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

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization BERKSHIRE MEDICAL CENTER INC

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization BERKSHIRE MEDICAL CENTER INC		Employer identification number 04-2791396

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 BERKSHIRE MEDICAL CENTER INC			Employer identification number 04-2791396
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

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 Bullet

Go 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

BERKSHIRE MEDICAL CENTER INC

Employer identification number

04-2791396

Part I-A

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

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

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

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 Bullet

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

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

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

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

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

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

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

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

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

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

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

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

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

Yes

43,265

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

43,265

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

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

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

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

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

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

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

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	LOBBYING ACTIVITIES EXPENDITURES BERKSHIRE MEDICAL CENTER PAYS ANNUAL MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE MASSACHUSETTS HOSPITAL ASSOCIATION (MHA). A PORTION OF THESE DUES ARE USED BY THE AHA AND THE MHA TO CONDUCT LOBBYING ACTIVITIES TO INCREASE THE BUDGET FOR MEDICARE AND MEDICAID FOR THE FYE 9/30/2022. CALCULATION OF THE LOBBYING FEE PORTION OF THE ANNUAL DUES ARE AS FOLLOWS: MHA LOBBYING FEES OF $26,933 ARE 14.15% OF THE $190,343 ANNUAL DUES. AHA LOBBYING FEES OF $16,332 ARE 27.29% OF THE $59,844 ANNUAL DUES.

Return Reference

Explanation

PART II-B, LINE 1:

LOBBYING ACTIVITIES EXPENDITURES BERKSHIRE MEDICAL CENTER PAYS ANNUAL MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE MASSACHUSETTS HOSPITAL ASSOCIATION (MHA). A PORTION OF THESE DUES ARE USED BY THE AHA AND THE MHA TO CONDUCT LOBBYING ACTIVITIES TO INCREASE THE BUDGET FOR MEDICARE AND MEDICAID FOR THE FYE 9/30/2022. CALCULATION OF THE LOBBYING FEE PORTION OF THE ANNUAL DUES ARE AS FOLLOWS: MHA LOBBYING FEES OF $26,933 ARE 14.15% OF THE $190,343 ANNUAL DUES. AHA LOBBYING FEES OF $16,332 ARE 27.29% OF THE $59,844 ANNUAL DUES.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

BERKSHIRE MEDICAL CENTER INC

Employer identification number

04-2791396

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

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

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

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

Yes No


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

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

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	35,358,308	30,131,752	28,399,191	27,603,974	26,030,698
b	Contributions ...
c	Net investment earnings, gains, and losses	-3,740,481	5,235,776	1,747,061	818,464	1,590,967
d	Grants or scholarships ...	-14,000	-8,500	-5,500	-6,500	-14,000
e	Other expenditures for facilities and programs ...	-20,393	-720	-9,000	-16,747	-3,692
f	Administrative expenses ....
g	End of year balance ......	31,583,433	35,358,308	30,131,752	28,399,191	27,603,974

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

24.960 %

Term endowment SchDMd Bullet

75.040 %

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

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

Yes

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

3a(i)

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

3a(ii)

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

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 .....	9,937,161		9,937,161
b	Buildings ....	290,914,365	192,536,424	98,377,941
c	Leasehold improvements
d	Equipment ....	373,803,409	312,901,117	60,902,292
e	Other .....	30,040,765	18,701,462	11,339,303
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				180,556,697

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........
(3) Other (A) INDEX FUND, LARGE BLEND	35,268,918	C
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	35,268,918

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.)

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.)...........

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
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	68,033,674
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

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

PART V, LINE 4:

THE ORGANIZATION HOLDS, INVESTS AND/OR UTILIZES ENDOWMENT FUNDS IN ACCORDANCE WITH ANY EXPRESSED WISH OF THE DONOR OF THOSE FUNDS. TO THE EXTENT THAT THE DONOR INSTRUCTIONS ALLOW THE EXPENDITURE OF THE ENDOWMENT FUNDS, THEY ARE EXPENDED FOR HEALTHCARE SERVICES PURPOSES SUCH AS FREE CARE AND SCHOLARSHIPS, CONSISTENT WITH THE TAX EXEMPTION OF THE ORGANIZATION.

PART X, LINE 2:

THE FINANCIAL ACTIVITIES OF BERKSHIRE MEDICAL CENTER, INC. ARE INCLUDED WITHIN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES AND SUPPLEMENTARY FINANCIAL INFORMATION FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021. THOSE FINANCIALS INCLUDE THE FOLLOWING FIN-48 FOOTNOTE: "THE HEALTH SYSTEM FOLLOWS THE ACCOUNTING GUIDANCE FOR UNCERTAINTIES IN INCOME TAX POSITONS, WHICH REQUIRES THAT A TAX POSITION BE RECOGNIZED OR DERECOGNIZED BASED ON A "MORE LIKELY THAN NOT" THRESHOLD. THE HEALTH SYSTEM HAS DETERMINED THAT THERE ARE NO SUCH POSITIONS, INDIVIDUALLY OR IN THE AGGREGATE, THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS."

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

BERKSHIRE MEDICAL CENTER INC

Employer identification number

04-2791396

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

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

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

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

Yes

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

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	782,294	68,967	713,327	0.120 %
b	Medicaid (from Worksheet 3, column a) . . . . .	90,094,832	70,678,142	19,416,690	3.290 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	8,843,533	12,545,952
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	99,720,659	83,293,061	20,130,017	3.410 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	5,263,776	2,437,106	2,826,670	0.480 %
f	Health professions education (from Worksheet 5) . . .	13,112,349	5,195,343	7,917,006	1.340 %
g	Subsidized health services (from Worksheet 6) . . . .	18,053,353	13,067,641	4,985,712	0.840 %
h	Research (from Worksheet 7) .	0	0
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	332,882	0	332,882	0.060 %
j	Total. Other Benefits . .	36,762,360	20,700,090	16,062,270	2.720 %
k	Total. Add lines 7d and 7j .	136,483,019	103,993,151	36,192,287	6.130 %

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.

		(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
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	521,407	27,443	493,964	0.080 %
9	Other
10	Total	521,407	27,443	493,964	0.080 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

9,635,237

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. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

177,768,116

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

280,744,776

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

-102,976,660

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 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)
1	BERKSHIRE MEDICAL CENTER 725 NORTH STREET PITTSFIELD,MA01201 WWW.BERKSHIREHEALTHSYSTEMS.ORG VQKK	X	X	X	X

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)

	BERKSHIRE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

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

Yes

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

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

Other website (list url):

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

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

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

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

Yes

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

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

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

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

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	BERKSHIRE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

SEE PART V SECTION C

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

SEE PART V SECTION C

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

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	BERKSHIRE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

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

	BERKSHIRE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 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
BERKSHIRE MEDICAL CENTER	PART V, SECTION B, LINE 5: THE BMC CHNA HAD ITS TRIANNUAL ASSESSMENT IN 2021 WHICH DIRECTED OUR EFFORTS FOR THIS REPORTING PERIOD OUR FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR 2021 RELIES HEAVILY UPON SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH FRAMEWORK AND THE ROBERT WOOD JOHNSON FOUNDATION'S COUNTY HEALTH RANKINGS TO ANALYZE AND PRIORITIZE THE FACTORS THAT CONTRIBUTE TO THE HEALTH OF A POPULATION. OUR ASSESSMENT INCLUDED THE EVALUATION OF PUBLICLY AVAILABLE DATA, FINDINGS FROM LOCAL ORGANIZATION REPORTS, AND FEEDBACK COLLECTED FROM FOCUS GROUPS AND SURVEYS. WE DEVELOPED OUR THREE-YEAR IMPLEMENTATION PLAN BASED ON THE 2021 CHNA. THE FOLLOWING IS A SUMMARY OF THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2021 CNHA, ORGANIZED INTO THREE OVERARCHING CATEGORIES:HEALTH CONDITIONS AND OUTCOMESCOMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTHBARRIERS TO ACCESSING QUALITY CAREHEALTH OUTCOMES AND BEHAVIORSCHRONIC DISEASE WITH A FOCUS ON CANCER, HEART DISEASE, AND DIABETESBERKSHIRE COUNTY HAS THE HIGHEST RATE OF PREMATURE DEATH IN THE COMMONWEALTH OF MASSACHUSETTS, ACCORDING TO THE ROBERT WOOD JOHNSON FOUNDATION'S COMMUNITY HEALTH RANKINGS (2021). RESIDENTS REPORT A HIGHER RATE OF POOR MENTAL HEALTH DAYS THAN THE STATE OVERALL, AND HAVE HIGHER RATES OF SMOKING (19%), OBESITY (27%) AND EXCESSIVE DRINKING (26%), ALL OF WHICH CONTRIBUTE TO HIGHER RATES OF CHRONIC DISEASE WITHIN THE COMMUNITY. MORE THAN 20% OF THE POPULATION IS OVER THE AGE OF 65, MAKING THE COMMUNITY HIGHLY SUSCEPTIBLE TO THE VARIETY OF INCREASED HEALTH ISSUES THAT ACCOMPANY AGING.MENTAL ILLNESS AND MENTAL HEALTH, INCLUDING SUICIDE PREVENTION AND TREATMENTIN ADDITION TO THE HIGH LEVEL OF REPORTED POOR MENTAL HEALTH DAYS IN THE BERKSHIRE COMMUNITY, RATES OF SUICIDE ARE AMONG THE HIGHEST IN THE STATE AT 17.4 PER 100,000. A RECENT SURVEY OF YOUTH REVEALED A SIMILARLY HIGH LEVEL OF SUICIDAL BEHAVIORS WITH BETWEEN 14-17% OF YOUTH STATING THAT THEY HAD PLANNED A SUICIDE ATTEMPT IN THE PAST 12 MONTHS AND 7-11% OF YOUTH HAVING ATTEMPTED SUICIDE IN THE PAST 12 MONTHS.SUBSTANCE USE DISORDERSBERKSHIRE COUNTY'S RATE OF SUBSTANCE USE HAS SKYROCKETED, AS EVIDENCED BY THE NEARLY 200% INCREASE IN OVERDOSE DEATHS IN THE PAST 10 YEARS. BERKSHIRE COUNTY ALSO REPORTS THE SECOND-HIGHEST RATE OF PREGNANT WOMEN WHO USED OPIOIDS DURING PREGNANCY.COVID-19 TESTING AND VACCINATIONBHS CONTINUES TO PROVIDE THE MAJOR INFRASTRUCTURE SUPPORTING THE COMMUNITY'S RESPONSE TO THE COVID-19 PANDEMIC. DURING THE HEALTH SYSTEM'S FISCAL YEAR ENDED 09/30/2021, BHS PERFORMED MORE THAN 160,000 COVID TESTS AND CARED FOR MORE THAN 500 HOSPITALIZED COVID-19 PATIENTS. COMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTHIMPROVING COMMUNITY SAFETYBERKSHIRE COUNTY RANKS 10TH OF 14 COUNTIES IN THE STATE FOR VIOLENT CRIMES, BUT 3RD IN THE STATE FOR HOMICIDE RISK AT 2.36 PER 100,000 PEOPLE.CREATING INITIATIVES TO IMPROVE SOCIAL DETERMINANTS OF HEALTHA VARIETY OF SOCIAL AND ECONOMIC ISSUES CONVERGE ON BERKSHIRE COUNTY TO CREATE SIGNIFICANT CHALLENGES THAT CAN IMPACT THE HEALTH OF ITS RESIDENTS. BERKSHIRE COUNTY FOLLOWS SUFFOLK AND HAMPDEN COUNTY, RANKING 3RD IN THE STATE (TIED WITH BRISTOL COUNTY) FOR PREVALENCE OF FOOD INSECURITY (9.9%). BERKSHIRE COUNTY HOUSING STOCK IS SIGNIFICANTLY OLDER THAN THE REST OF THE STATE, WITH MORE THAN 45% OF ALL HOUSING BEING BUILT BEFORE 1950, AS OPPOSED TO ONLY 37% FOR THE REST OF THE STATE. THE COUNTY'S MEDIAN HOUSEHOLD INCOME IS AT LEAST 25% LOWER THAN THE STATE AVERAGE AND A HIGHER NUMBER OF CHILDREN UNDER 18 LIVE BELOW THE POVERTY LEVEL (13.9%).BARRIERS TO ACCESSING QUALITY CAREINCREASING INSURANCE ENROLLMENTGIVEN THE AGE AND ECONOMIC DEMOGRAPHIC OF THE COUNTY, MORE THAN 45% OF BERKSHIRE RESIDENTS ARE HEAVILY RELIANT ON PUBLIC SOURCES OF FINANCING FOR ACCESS TO HEALTH CARE. NEARLY 3.0% ARE UNINSURED. ENHANCING THE HEALTHCARE WORKFORCETHE REGION'S SIGNIFICANT RELIANCE ON GOVERNMENT-REIMBURSED SERVICES CAN HAVE A DIRECT INFLUENCE ON LOCALLY AVAILABLE PROGRAMS AND SERVICES. BHS CONTINUES TO FACE STAFFING CHALLENGES, LIKE THOSE EXPERIENCED ACROSS THE NATION AND IS EXPLORING CAREER TRAINING PROGRAMS THAT CAN SIMULTANEOUSLY HELP TO REDUCE CLINICIAN SHORTAGES AND HELP TO RAISE MEDIAN INCOME LEVELS THROUGH STRONG EMPLOYMENT OPPORTUNITIES FOR BERKSHIRE RESIDENTS.CONTINUED ON SCHEDULE O
BERKSHIRE MEDICAL CENTER	PART V, SECTION B, LINE 6A: FAIRVIEW HOSPITAL
BERKSHIRE MEDICAL CENTER	PART V, SECTION B, LINE 11: BERKSHIRE MEDICAL CENTER (BMC) REGULARLY ASSESSES THE HEALTH NEEDS OF BERKSHIRE COUNTY RESIDENTS AS PART OF THE STRATEGIC PLANNING PROCESS AND COMMUNITY BENEFITS PROGRAMMING. BMC COMPILED THE BERKSHIRE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT USING THE EVALUATION OF PUBLICLY AVAILABLE DATA, FINDINGS FROM LOCAL ORGANIZATION REPORTS, AND FEEDBACK COLLECTED FROM FOCUS GROUPS AND SURVEYS. THIS DATA, IN CONJUNCTION WITH THE MASSACHUSETTS FOCUS AREAS AND PRIORITIES, WAS USED TO DETERMINE OUR ANNUAL COMMUNITY BENEFIT PRIORITIES. THE INTENT IS TO BROADLY IDENTIFY THE MAJOR TRENDS IN HEALTH STATUS AND OUR COMMUNITY'S HEALTH NEEDS WITH AN UNDERSTANDING OF THE FACTORS THAT ARE LIKELY TO AFFECT THE POPULATION OF BERKSHIRE COUNTY. THE FRAMEWORK OF THIS PLAN SPANS FISCAL YEARS 2021-2024. THE OBJECTIVES OF THE CHNA ARE TO: TO GATHER STATISTICALLY VALID INFORMATION ON THE HEALTH STATUS OF THE RESIDENTS OF BERKSHIRE COUNTY TO DEVELOP ACCURATE COMPARISONS TO STATE AND NATIONAL BENCHMARKS OF HEALTH AND QUALITY OF LIFE MEASURES TO PROVIDE TRENDING INFORMATION FOR THE FUTURE TO IDENTIFY KEY AREAS OF SIGNIFICANT COMMUNITY NEEDS AND VULNERABLE POPULATIONS TO UTILIZE FINDINGS FOR COMMUNITY BENEFIT AND HOSPITAL PLANNING WHILE DEMOGRAPHIC, SOCIOECONOMIC AND HEALTH STATUS INDICATORS PROVIDE AN EFFECTIVE MEANS OF IDENTIFYING POTENTIAL NEEDS AND/OR PROBLEMS, SUCH A BROAD-BASED VIEW CANNOT IDENTIFY ALL OF THE HEALTH AND HUMAN SERVICE PROBLEMS FACING A COMMUNITY. THIS IS RATHER ONE STEP OF MANY IN AN ON-GOING PROCESS OF COLLECTING AND DISSEMINATING HEALTH STATUS INFORMATION SO THAT, WORKING TOGETHER WE ADDRESS MOST OF THE IDENTIFIED HEALTH NEEDS OF OUR COMMUNITY AND HELP TO ENSURE BETTER OUTCOMES FOR ALL THE PEOPLE LIVING IN BERKSHIRE COUNTY. ADDITIONALLY, AN IMPORTANT PART OF THIS PROCESS IS TO IDENTIFY PREEXISTING PROGRAMS AND RESOURCES IN THE COMMUNITY TO AVOID DUPLICATION OF EFFORTS AND SILOED WORK. WE KNOW THAT COLLABORATING WITH OUR PARTNERS WE CAN BUILD A STRONGER MORE RESILIENT COMMUNITY THAT CAN ADDRESS MOST OF OUR COMMUNITY NEEDS. WHEN PARTNER ORGANIZATIONS ARE ALREADY ADDRESSING A PRIORITY HEALTH NEED, BMC MAY NOT PROVIDE DIRECT SERVICE OR FUNDS HOWEVER SUPPORTS THAT PROGRAM BY PROVIDING REFERRALS, CONNECTIONS, DATA, AND/OR OTHER MODALITIES OF SUPPORT. BASED ON THIS APPROACH, MOST OF THE IDENTIFIED HEALTH NEEDS ARE BEING ADDRESSED BY BMC OR PARTNER ORGANIZATIONS. COMMUNITY BENEFIT AND ACCESS COMMITTEE:AS A STANDING COMMITTEE OF THE BOARD OF TRUSTEES - ITSELF MADE UP OF COMMUNITY VOLUNTEERS, THIS COMMITTEE IS RESPONSIBLE FOR UNDERSTANDING THE HEALTH NEEDS AND BARRIERS TO CARE IN OUR SERVICE AREA. THE COMMITTEE OVERSEES THE COMMUNITY BENEFIT PROCESS OF THE ORGANIZATION, INCLUDING HEALTH NEEDS ASSESSMENTS, DETERMINING TARGET POPULATIONS AND PRIORITIES, DEVELOPMENT OF THE COMMUNITY BENEFITS PLAN AND EVALUATING PERFORMANCE AGAINST GOALS AND OBJECTIVES. THE COMMITTEE IS COMPRISED OF PEOPLE FROM THE BOARD OF TRUSTEES AND THE COMMUNITY AT LARGE. THE BMC COMMUNITY BENEFITS AND ACCESS COMMITTEE REVIEWS AND DISCUSSES COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, AND COMMUNITY NEEDS AND OUTCOMES. THE COMMITTEE FORMALLY REVIEWS ANY UPDATES TO COMMUNITY NEEDS AND REAFFIRMS PRIORITIES ANNUALLY AND COMPLETES A COMPREHENSIVE NEEDS ASSESSMENT EVERY THREE YEARS. THROUGHOUT THE YEAR, INTERNAL COMMUNITY BENEFITS AND PROGRAM LEADERS MEET TO COORDINATE THE COMMUNITY BENEFIT PLAN AND PROGRAMS. DUE TO THE COVID-19 PANDEMIC THIS COMMITTEE DID NOT MEET AS MANY OF THE PARTICIPANTS HAD COMPETING PRIORITIES. OUR COMMUNITY BENEFIT AND ACCESS COMMITTEE ALSO INCURRED CHANGES IN ITS LEADERSHIP STRUCTURE.BMC IS THE ONLY HEALTH SYSTEM IN BERKSHIRE COUNTY AND THEREFORE WE ASSUME A SIGNIFICANT LEADERSHIP ROLE IN ADDRESSING THE PRIORITIES IDENTIFIED IN THE CHNA. WE ARE FORTUNATE TO WORK COLLABORATIVELY WITH MANY COMMUNITY ORGANIZATIONS. BERKSHIRE MEDICAL CENTER HAS A STRONG REPUTATION AS A LEADER AND COLLABORATOR IN MEETING COMMUNITY HEALTH NEEDS THROUGH ITS ONGOING COMMUNITY BENEFIT PROGRAMS AND SERVICES. BMC PLANS TO PROVIDE COMMUNITY BENEFIT PROGRAMS IN RESPONSE TO THE HEALTH NEEDS IDENTIFIED IN THE 2021-2024 COMMUNITY HEALTH NEEDS ASSESSMENT. THESE INCLUDE, BUT ARE NOT LIMITED TO, HEALTH EDUCATION PROGRAMS, SCREENINGS, SUPPORT GROUPS, MENTAL HEALTH SERVICES, AND OTHER COMMUNITY HEALTH IMPROVEMENT SERVICES AND ACCESS TO CARE THROUGH SEVERAL LEVERAGED SOURCES (GRANTS). BMC UNDERSTANDS THAT THE NEEDS OF THE COMMUNITY ARE FLUID AND MAY CHANGE WITH CIRCUMSTANCE AND TIME, IN RESPONSE STRATEGIES MAY ALSO CHANGE, AND PROGRAMS MAY BE ADDED OR ELIMINATED DURING THE 2021-2024 TIMEFRAME. LISTED BELOW ARE THE HOSPITAL'S FY21 STRATEGIC PRIORITY HEALTH NEEDS, AND HOW EACH IS ADDRESSED. THE FY21 PRIORITY HEALTH NEEDS ARE UPDATED FROM THE TRIANNUAL FY21 CHNA. BMC HAS IDENTIFIED THE FOLLOWING PRIORITY NEEDS AREAS: BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER, CHRONIC CONDITIONS AND INFECTIOUS DISEASE, ACCESS TO CARE, SOCIAL ECONOMIC, AND WORKFORCE DEVELOPMENT. THESE PRIORITY NEEDS ARE LISTED BELOW WITH SUPPLEMENTATION OF WHAT IS BEING DONE BY THE HOSPITAL REGARDING EACH NEED. PLEASE NOTE, THE LISTS ARE NOT EXHAUSTIVE BUT ARE INTENDED TO PROVIDE AN OVERVIEW. BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER:SUBSTANCE USE/ OPIOIDS - BMC HAS INPATIENT SUBSTANCE USE TREATMENT PROGRAMS, INCLUDING THE MCGEE RECOVERY CENTER, A DETOX PROGRAM, AND OUR CLINICAL STABILIZATION SERVICES UNIT, WHICH GIVES THOSE IN RECOVERY THE OPPORTUNITY TO STAY, UP TO 30 DAYS, IN A SAFE SETTING THAT AIDS IN LONG-TERM RECOVERY. BMC ALSO PARTNERS WITH THE BRIEN CENTER FOR SUBSTANCE USE SERVICES IN PROVIDING ACCESS TO OUTPATIENT PROGRAMS TO ENHANCE TREATMENT FOR ADDICTION. THE SUBSTANCE USE TREATMENT CLINIC DEVELOPED IN 2019 IS PROVIDED BY A MEDICATION ASSISTED TREATMENT (MAT) CERTIFIED NURSE PRACTITIONER AND REGISTERED NURSE WHO PROVIDE TREATMENTS RELATED TO ALL FORMS OF SUBSTANCE USE DISORDERS AND PRACTICE USING THE HARM REDUCTION MODEL OF CARE. CARE INCLUDES SUPPORT, MEDICATIONS INCLUDING INDUCTIONS, ORAL, SUBLINGUAL, INJECTABLE AND TRANSDERMAL FORMULATIONS. COORDINATES CARE WITH THE PATIENT'S PRIMARY CARE PHYSICIAN AND SOCIAL SERVICES. THE GOAL OF THE PROGRAM IS TO HELP MANAGE THEIR SUBSTANCE USE DISORDER, REDUCE EMERGENCY DEPARTMENT UTILIZATION, AND REDUCE INPATIENT AND OBSERVATION ADMISSIONS. THE PROVIDERS ARE BOTH CERTIFIED RECOVERY COACHES. RECRUITMENT FOR OTHER POSITIONS SUCH AS COMMUNITY HEALTH WORKER/RECOVERY COACH AND MEDICAL ASSISTANT HAS BEEN CHALLENGING. MENTAL HEALTH-DEPRESSION, SUICIDE - THE BMC DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL HEALTH PROVIDES ANNUAL FREE DEPRESSION SCREENINGS IN THE COMMUNITY, PARTNERS WITH THE BRIEN CENTER FOR MENTAL HEALTH AND SUBSTANCE USE SERVICES ON OUTPATIENT PROGRAMS AND PROVIDES AN EMPLOYEE ASSISTANCE PROGRAM TO COMPANIES IN THE COMMUNITY TO AID IN RESPONDING TO MENTAL HEALTH ISSUES. CHRONIC CONDITIONS & INFECTIOUS DISEASECANCER - IN ADDITION TO PROVIDING COMPREHENSIVE HEMATOLOGY AND RADIATION ONCOLOGY SERVICES THROUGH THE BMC CANCER CENTER, BMC HAS COMMUNITY PROGRAMS ENCOURAGING AND PROMOTING CANCER SCREENING, SUCH AS COLONOSCOPY, MAMMOGRAPHY, AND LUNG CANCER. FOR COLONOSCOPY AND MAMMOGRAPHY, BMC ALSO PROVIDES PATIENT ASSISTANCE FUNDS TO HELP THOSE AT RISK TO PAY FOR POTENTIAL HIGH CO-PAYS FOR THESE PREVENTION SCREENINGS. CARDIOVASCULAR HEALTH - BERKSHIRE MEDICAL CENTER PROVIDES COMPREHENSIVE CARDIOVASCULAR HEALTH SERVICES THROUGH OUR PHYSICIAN PRACTICES. THE WELLNESS AT WORK PROGRAM PROVIDES CARDIOVASCULAR SCREENINGS FOR BUSINESSES AND EMPLOYEES. AS WELL AS FREE COMMUNITY BLOOD PRESSURE SCREENINGS. DIABETES - BMC HAS A DIABETES EDUCATION PROGRAM THAT WORKS WITH PEOPLE DIAGNOSED WITH PRE-DIABETES, AND TYPE 1 AND 2 DIABETES, PROVIDING ONE-ON-ONE COUNSELING AND SUPPORT, INCLUDING ACCESS TO NUTRITION SERVICES. INFECTIOUS DISEASE - BMC'S INFECTION PREVENTION AND CONTROL DEPARTMENT WORKS BOTH IN THE HOSPITAL AND IN THE COMMUNITY TO CURB INFECTIOUS DISEASE, INCLUDING COVID-19, INFLUENZA, LYME DISEASE, AND MANY OTHERS. STROKE/BLOOD PRESSURE - BMC IS A DEDICATED STROKE CENTER AND REGULARLY PROVIDES COMMUNITY LECTURES AND PROGRAMS THAT EDUCATE RESIDENTS ON THE RISK FACTORS AND WARNING SIGNS FOR STROKE, AND HOW TO RESPOND. SEXUALLY TRANSMITTED DISEASE/ INFECTION - BMC'S INFECTION PREVENTION AND CONTROL DEPARTMENT WORKS BOTH IN THE HOSPITAL AND IN THE COMMUNITY TO CURB INFECTIOUS DISEASE, INCLUDING INFLUENZA, LYME DISEASE, AND MANY OTHERS. BERKSHIRE HARM REDUCTION PROGRAM EMBRACES AN APPROACH THAT FOCUSES ON HELPING PEOPLE WHO USE DRUGS REDUCE THEIR HIGH-RISK BEHAVIOR AND THE HARM ASSOCIATED WITH DRUG USE.CONTINUE ON SCHEDULE O
PART V, SECTION B LINE 7A	THE HOSPITAL'S 2021 CHNA REPORT IS AVAILABLE ON THE HOSPITAL WEBSITE, HTTPS://WWW.BERKSHIREHEALTHSYSTEMS.ORG/PROGRAMS-AND-SERVICES/COMMUNITY-WELLNESS/CLICK ON THE LINK FOR COMMUNITY BENEFIT REPORT BMC FY 2021
PART V SECTION B LINE 10A	THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE ON THE HOSPITAL WEBSITE,HTTPS://WWW.BERKSHIREHEALTHSYSTEMS.ORG/PROGRAMS-AND-SERVICES/COMMUNITY-WELLNESS/CLICK ON THE LINK FOR COMMUNITY BENEFIT REPORT BMC FY 2021.
PART V SECTION B LINE 16A	THE HOSPITAL'S FAP IS AVAILABLE ON THE HOSPITAL WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/ABOUT/POLICIES-AND-NOTICES, SELECT FINANCIAL ASSISTANCE POLICY DROP DOWN BOX, SELECT DOCUMENT "FINANCIAL ASSISTANCE POLICY - BERKSHIRE HEALTH SYSTEMS".
PART V SECTION B LINE 16B	THE HOSPITAL'S FAP APPLICATION IS AVAILABLE ON THE HOSPITAL WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/ABOUT/POLICIES-AND-NOTICES, SELECT FINANCIAL ASSISTANCE POLICY DROP DOWN BOX, THEN SELECT THE DOCUMENT "FINANCIAL ASSISTANCE APPLICATION".
PART V SECTION B LINE 16C	THE HOSPITAL'S PLAIN LANGUAGE SUMMARY OF THE FAP IS AVAILABLE ON THE HOSPITAL WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/ABOUT/POLICIES-AND-NOTICES, SELECT FINANCIAL ASSISTANCE POLICY DROP DOWN BOX, THEN SELECT THE DOCUMENT "PLAIN LANGUAGE SUMMARY OF FINANCIAL ASSISTANCE POLICIES".

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

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 7:	THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINES 7A, 7B, & 7C HAS BEEN CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AS COMPUTED USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINE 7G HAS BEEN CALCULATED USING A COST ACCOUNTING METHOD.
PART I, LINE 7G:	OUR COMMUNITY BENEFITS WHICH ARE SUBSIDIZED ARE THE SUBSTANCE ABUSE UNIT, CLINICAL STABILIZATION SERVICES, RENAL DIALYSIS SERVICES, AND THE INPATIENT PYSCHIATRIC UNIT.
PART I, LN 7 COL(F):	BAD DEBT EXPENSE OF $9,635,237 ATTRIBUTABLE TO PATIENT ACCOUNTS HAS BEEN EXCLUDED FROM THE COMPUTATION OF ALL COMMUNITY BENEFIT EXPENSE SHOWN IN PART I, LINE 7, COLUMN F.
PART I, LINE 6A	FAIRVIEW HOSPITAL AND BERKSHIRE MEDICAL CENTER EACH FILE A SEPARATE COMMUNITY BENEFITS REPORT WITH THE STATE OF MASSACHUSETTS. BMC'S FISCAL YEAR 2021 COMMUNITY BENEFITS REPORT CAN BE ACCESSED AT HTTPS://MASSCHARITIES.MY.SITE.COM/FILINGSEARCH/S/DETAIL/A095E000009HDTMAA0
PART II, COMMUNITY BUILDING ACTIVITIES:	WORKFORCE DEVELOPMENT $493,964: RECRUITMENT OF STAFF
PART III, LINE 2:	THE HOSPITAL REPORTS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE AMOUNTS BASED UPON ACTUAL WRITE-OFF'S, A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS AND TRENDS.
PART III, LINE 4:	FOOTNOTE 2 (PROVISION FOR BAD DEBT) TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SUPPLEMENTARY FINANCIAL INFORMATION OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES (INCLUDING BERKSHIRE MEDICAL CENTER) FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021 ARE LISTED ON PAGE 13 UNDER "PATIENT ACCOUNTS RECEIVABLE".
PART III, LINE 8:	THE AMOUNT REPORTED ON LINE 6, PART III WAS DETERMINED USING THE COST ALLOCATION METHODOLOGY USED FOR THE MEDICARE COST REPORTS. THE LOSS ON MEDICARE ACTIVITY AS REPORTED IN PART III, LINE 7 IS A COMMUNITY BENEFIT BECAUSE IT IS THE MISSION OF BERKSHIRE MEDICAL CENTER TO PROVIDE HIGH QUALITY HEALTH CARE TO RESIDENTS OF BERKSHIRE COUNTY REGARDLESS OF THEIR ABILITY TO PAY. THE COST TO PROVIDE SERVICES TO MEDICARE BENEFICIARIES OFTEN EXCEEDS THE REIMBURSEMENT FOR SUCH SERVICES. ELDERLY PATIENTS ARE AMONG THE MOST NEEDY IN OUR COMMUNITY AND PROVIDING SERVICES TO THEM CLOSE TO HOME IMPROVES THE QUALITY OF THEIR CARE, INCREASES ACCESS AND ENHANCES HEALTH AND WELLNESS FOR THIS POPULATION. SERVICES SUCH AS EMERGENCY CARE, CARDIAC SERVICES, PSYCHIATRIC CARE, RENAL DIALYSIS AND WOUND CARE SERVICES ARE AMONG THOSE THAT PROVIDE A SIGNIFICANT BENEFIT TO THE FRAIL ELDERLY. THE BREADTH OF ACUTE AND AMBULATORY SERVICES PROVIDED BY BMC MEANS THAT THE MEDICARE BENEFICIARIES IN OUR COUNTY DO NOT HAVE TO LEAVE THE COUNTY FOR MOST SERVICES.
PART III, LINE 9B:	POPULATIONS EXEMPT FROM COLLECTION ACTIVITIESTHE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS:A. PATIENTS ENROLLED IN A STATE HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN, "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID.1. PLEASE NOTE THAT BMC MAY SEEK COLLECTION ACTION AGAINST ANY PATIENT ENROLLED IN THE ABOVE MENTIONED PROGRAMS FOR THEIR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM.2. BMC MAY ALSO INITIATE BILLING OR COLLECTION FOR A PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT FAILS TO PROVIDE PROOF OF SUCH PARTICIPATION. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM, (INCLUDING RECEIPT OR VERIFICATION OF SIGNED APPLICATION) BMC SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES. 3. BMC MAY CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED OR EXPIRED. HOWEVER, ONCE A PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN COMMONWEALTH CARE PROGRAMS, BMC WILL CEASE COLLECTION ACTIVITY FOR SERVICES, PREVIOUSLY BILLED, THAT NOW FALL INTO THE ELIGIBILITY PERIOD. 4. BMC MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE.5. BMC WILL NOT UNDERTAKE COLLECTION ACTION AGAINST AN INDIVIDUAL THAT HAS BEEN APPROVED FOR MEDICAL HARDSHIP UNDER THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM WITH RESPECT TO THE AMOUNT OF THE BILL THAT EXCEEDS THE MEDICAL HARDSHIP CONTRIBUTION.B. BMC DOES NOT GARNISH A PATIENT'S OR THE PATIENT'S GUARANTOR'S WAGES OR EXECUTE A LIEN ON THE PATIENT'S OR THE PATIENT'S GUARANTOR'S PERSONAL RESIDENCE OR MOTOR VEHICLE. C. BMC AND ITS AGENTS SHALL NOT CONTINUE COLLECTION OR BILLING ON A PATIENT WHO IS A MEMBER OF A BANKRUPTCY PROCEEDING EXCEPT TO SECURE ITS RIGHTS AS A CREDITOR IN THE APPROPRIATE ORDER.
PART VI, LINE 2:	COMMUNITY BENEFITS MISSION STATEMENT:FURTHERING OUR CHARITABLE PURPOSE, THE BERKSHIRE MEDICAL CENTER'S (BMC) COMMUNITY BENEFIT MISSION IS TO IDENTIFY, PRIORITIZE AND INVEST IN OUR COMMUNITY'S HEALTH NEEDS BY PURSUING NEEDED INITIATIVES AND PROGRAMS. THE COMMUNITY BENEFIT GOALS INCLUDE SATISFYING UNMET NEEDS IN THE BERKSHIRES AND IMPROVING THE HEALTH STATUS OF OUR COMMUNITY WITH A PARTICULAR FOCUS ON ACCESS TO HEALTHCARE AND "AT RISK" POPULATIONS. RECOGNIZING THE VALUE OF BMC'S PARTNERSHIP WITH OUR COMMUNITY, BMC WILL SEEK INPUT AND MEANINGFUL COLLABORATION IN OUR EFFORT TO MEET COMMUNITY NEED. BMC WILL OUTLINE IN AN ANNUAL COMMUNITY BENEFIT PLAN, THE PRIORITIES TO BE ADDRESSED AND THE INITIATIVES TO BE FUNDED.BMC AND FAIRVIEW HOSPITAL ARE BOTH PART OF BERKSHIRE HEALTH SYSTEMS AND THEREFORE WORK TOGETHER TO MEET COMMUNITY NEED. COMMUNITY BENEFIT AND ACCESS COMMITTEE:AS A STANDING COMMITTEE OF THE BOARD OF TRUSTEES - ITSELF MADE UP OF COMMUNITY VOLUNTEERS, THIS COMMITTEE IS RESPONSIBLE FOR UNDERSTANDING THE HEALTH NEEDS AND BARRIERS TO CARE IN OUR SERVICE AREA. THE COMMITTEE OVERSEES THE COMMUNITY BENEFIT PROCESS OF THE ORGANIZATION, INCLUDING HEALTH NEEDS ASSESSMENTS, DETERMINING TARGET POPULATIONS AND PRIORITIES, DEVELOPMENT OF THE COMMUNITY BENEFITS PLAN AND EVALUATING PERFORMANCE AGAINST GOALS AND OBJECTIVES. THE COMMITTEE IS COMPRISED OF PEOPLE FROM THE BOARD OF TRUSTEES AND THE COMMUNITY AT LARGE AND MEETS MONTHLY THOUGH OUT THE YEAR. COMMUNITY BENEFITS LEADERSHIP/TEAM:THE BHS COMMUNITY BENEFITS AND ACCESS COMMITTEE MEETS TO DISCUSS COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, COMMUNITY NEEDS AND OUTCOMES. IN 2021 THE COMMUNITY BENEFIT AND ACCESS COMMITTEE DID NOT MEET DUE TO THE COVID-19 PANDEMIC. COMMUNITY BENEFITS MEETINGS:THE BHS COMMUNITY BENEFITS AND ACCESS COMMITTEE MEETS TO DISCUSS COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, COMMUNITY NEEDS AND OUTCOMES. IN 2022 THE COMMUNITY BENEFIT AND ACCESS COMMITTEE DID NOT MEET DUE TO THE COVID-19 PANDEMIC. THE COMMUNITY BENEFIT AND ACCESS COMMITTEE IS CURRENTLY BEING RESTRUCTURED. COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)BMC HAS UTILIZED AN ACTIVE COMMUNITY NEEDS ASSESSMENT AS PART OF ITS COMMUNITY BENEFIT PROCESS SINCE 1996. THE COMMUNITY NEEDS ASSESSMENT IS UPDATED ANNUALLY, WITH A COMPLETE ASSESSMENT DONE EVERY THREE YEARS. THE LAST CHNA WAS COMPLETED IN THE FALL OF 2021. BMC UTILIZED ALL AVAILABLE CLINICAL, HEALTH STATUS, DEMOGRAPHIC, AND SOCIO-ECONOMIC DATA AVAILABLE TO FORM THE FOUNDATION OF OUR NEEDS ASSESSMENT. IN ADDITION, WE GATHERED AVAILABLE QUALITATIVE DATA FROM OUR MANY ADVISORY GROUPS, COMMUNITY FORUMS, SURVEYS, AND FOCUS GROUPS. THE WELLNESS AND OUTREACH PROGRAMS ALSO SUPPLEMENT OUR UNDERSTANDING OF THE HEALTH STATUS OF OUR COMMUNITY, HEALTH RISK FACTORS, AND BARRIERS TO HEALTH AND HEALTH CARE. THE FEEDBACK GATHERED INPUT ON SPECIFIC ACTIONS THAT COULD BE TAKEN AT AN INDIVIDUAL, FAMILY, AND ORGANIZATIONAL LEVEL AS WELL AS IDENTIFYING GAPS IN SERVICE IN ADDITION TO PRIORITIZING THE MOST IMPORTANT NEEDS FOR THE COMMUNITY. WE HAVE CONVENED THIS COMMUNITY GROUP AT LEAST ANNUALLY TO REVIEW DATA, CONFIRM PRIORITIES, DISCUSS NEEDS, AND WORK TOGETHER TO ADDRESS THE IDENTIFIED PRIORIES AND NEEDS. THE NEEDS DATA, ALONG WITH STATE PRIORITIES ARE USED TO DETERMINE OUR ANNUAL COMMUNITY BENEFIT PRIORITIES. IN ITS PLANNING, BMC LOOKS FOR OPPORTUNITIES TO MAKE BETTER AND MORE EFFECTIVE USE OF EXISTING RESOURCES AND PROVIDERS, AS WELL AS TO IDENTIFY GAPS IN SERVICE AND SEEKS OUT AVAILABLE GRANTS TO FACILITATE MEETING COMMUNITY NEED. BMC WORKS WITH INTERNAL RESOURCES AND COMMUNITY AND REGIONAL PARTNERS, WITH THE HELP OF EVIDENCED BASED OR BEST PRACTICE PROGRAMS, TO DEVELOP AND IMPLEMENT PROGRAMS AND INITIATIVES TO MEET COMMUNITY NEED. DATA SOURCESCOMMUNITY FOCUS GROUPS, HOSPITAL DATA, CONSUMER AND ADVISORY GROUPS, INTERVIEWS, MASS CHIP, PUBLIC HEALTH PERSONNEL, SURVEYS, OTHER - HEALTHYPEOPLE.GOV; DEPARTMENT OF PUBLIC HEALTH BUREAU OF FAMILY AND COMMUNITY HEALTH INJURY REPORT; COUNTY HEALTH RANKINGS, DEPARTMENT OF PUBLIC HEALTH PRESCRIPTION MONITORING PROGRAM DATA; PHYSICIAN MANPOWER DATA; WORKFORCE NEEDS DATA; WELLNESS AT WORK DATA; EMERGENCY DEPARTMENT/TRAUMA REGISTRY; BERKSHIRE UNITED WAY; NORTHERN BERKSHIRE COMMUNITY COALITION, BERKSHIRE REGIONAL PLANNING COMMISSION; AND YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM DATA. GOALS: STATEWIDE PRIORITIES AS PART OF OUR PLANNING PROCESS, BHS INCORPORATES THE MASSACHUSETTS STATEWIDE PRIORITIES AND THE MA DEPARTMENT OF PUBLIC HEALTH PRIORITIES TO GUIDE THE INVESTMENTS FUNDED BY THE DETERMINATION OF NEED PROCESS AS PART OF OUR LOCAL ASSESSMENT, PRIORITIES AND INITIATIVES. THE COMMONWEALTH'S PRIORITIES ARE: CHRONIC DISEASE (WITH A FOCUS ON CANCER, HEART DISEASE, & DIABETES), HOUSING STABILITY/HOMELESSNESS, MENTAL ILLNESS & MENTAL HEALTH, AND SUBSTANCE USE DISORDERS. THE DEPARTMENT OF PUBLIC HEALTH'S PRIORITIES ARE: BUILT ENVIRONMENT, SOCIAL ENVIRONMENT, HOUSING, VIOLENCE, EDUCATION AND EMPLOYMENT COMMUNITY BENEFIT TARGET POPULATIONS:CHILDREN/ADOLESCENTS OLDER ADULTS MEDICALLY UNDERSERVED COMMUNITY BENEFIT PRIORITIES:BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER CHRONIC CONDITIONS & INFECTIOUS DISEASE ACCESS TO CARE SOCIAL ECONOMIC WORKFORCE DEVELOPMENT COMMUNITY PARTNERSBEACON RECOVERY COMMUNITY CENTER, BERKSHIRE AHEC, BERKSHIRE BOUNTY, BERKSHIRE BREAST HEALTH TEAM, BERKSHIRE COMMUNITY ACTION COUNCIL, BERKSHIRE COMMUNITY PROVIDERS, BERKSHIRE COUNTY BOARDS OF HEALTH, BERKSHIRE COUNTY COURT SYSTEM, BERKSHIRE COUNTY FIRE DEPARTMENTS, BERKSHIRE COUNTY REGIONAL EMERGENCY OPERATIONS PLANNING COMMITTEE, BERKSHIRE COUNTY REGIONAL HOUSING AUTHORITY, BERKSHIRE COUNTY REGIONAL PLANNING COMMISSION, BERKSHIRE COUNTY SHERIFF'S OFFICE, BERKSHIRE DISTRICT ATTORNEY OFFICE, BERKSHIRE EMERGENCY NURSE'S ASSOCIATION, BERKSHIRE FACILITIES SERVICES, BERKSHIRE FALLON HEALTH COLLABORATIVE, BERKSHIRE IMMIGRANT CENTER, BERKSHIRE OB-GYN, BERKSHIRE OPIOID ADDICTION PREVENTION COLLABORATIVE (BOAPC), BERKSHIRE UNITED WAY, BERKSHIRE YOUTH DEVELOPMENT PROJECT, BOARDS OF HEALTH: TRI-TOWN HEALTH DEPARTMENT, BERKSHIRE COUNTY BOARDS OF HEALTH AND PITTSFIELD HEALTH DEPARTMENT, THE BRIEN CENTER FOR MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES, CHILD CARE OF THE BERKSHIRES, CLINICAL SUPPORT OPTIONS, COMMUNITY HEALTH PROGRAMS, EDUCATIONAL INSTITUTIONS (LOCAL SCHOOL DISTRICTS, BERKSHIRE COMMUNITY COLLEGE, MASSACHUSETTS COLLEGE OF LIBERAL ARTS, WILLIAMS COLLEGE, UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL), ELDER SERVICES OF BERKSHIRE COUNTY/ SENIOR CENTERS/COUNCILS ON AGING/RVSP/SHINE, FOOD BANK OF WESTERN MA, GREYLOCK FEDERAL CREDIT UNION, HOME-CARE AGENCIES, INNOVATIVE CARE PARTNERS, JUVENILE AND ADULT PROBATION, KEENAN HOUSE, LOCAL BUSINESS COMMUNITY, LOCAL EMERGENCY MANAGEMENT SERVICES/PITTSFIELD POLICE DEPARTMENT, LOCAL HIRING AGENCIES, LOCAL SHELTERS, FOOD PANTRIES, DAY PROGRAMS, ETC., MCGEE RECOVERY CENTER, MOTHER'S IN RECOVERY, NORTHERN BERKSHIRE COMMUNITY COALITION, PHYSICIAN AND SPECIAL PROVIDER OFFICES, RECREATIONAL (BERKSHIRE BOYS AND GIRLS CLUB, BERKSHIRE FAMILY YMCA, BERKSHIRE SOUTH), REGIONAL PAIN COLLABORATIVE, SERVICENET, THINK FIRST, VOLUNTEERS IN MEDICINE, WIC (WOMEN, INFANTS, AND CHILDREN), ZERO SUICIDEPROGRAM PLANNING AND EVALUATIONTHE COMMUNITY HEALTH NEEDS ASSESSMENT IS USED TO FOCUS OUR COMMUNITY BENEFIT PROGRAM AND INITIATIVE PLANNING AS WELL AS TO MONITOR RESULTS AND REPRIORITIZE FOR FUTURE EFFORTS.
PART VI, LINE 3:	BMC PROMINENTLY ADVERTISES THROUGHOUT THE COMMUNITY, AT ALL OF ITS FACILITIES, AND ON ITS WEBSITE ITS ADVOCACY FOR ACCESS PROGRAM. THE GOAL OF THIS PROGRAM IS TO ASSIST THE UNINSURED AND UNDERINSURED IN BERKSHIRE COUNTY IN ACCESSING VARIOUS FEDERAL, STATE, OR LOCAL PROGRAMS THAT CAN PAY FOR HEALTHCARE SERVICES, AS WELL AS INFORM PATIENTS ABOUT OTHER AVENUES THEY CAN ACCESS TO RECEIVE HEALTHCARE SERVICES AT NO COST. ADVOCACY FOR ACCESS HELPS REDUCE THE PERCEPTION THAT AN INABILITY TO PAY FOR HEALTHCARE IS A BARRIER TO RECEIVING CARE. ADVOCACY FOR ACCESS STAFF FACILITATE THE APPLICATION AND ENROLLMENT PROCESS OF INDIVIDUALS AND FAMILIES WHO LIVE IN MASSACHUSETTS INTO QUALIFIED HEALTH PLANS THROUGH THE MARKETPLACE AND/OR OTHER HEALTH INSURANCE PROGRAMS SUCH AS MEDICAID AND CHIP, AND ASSIST QUALIFIED INDIVIDUALS IN MAKING INFORMED DECISIONS ON THE SELECTION OF A HEALTH PLAN. THE STAFF RECOGNIZES THAT MANY OF THESE STATE AND FEDERAL PROGRAMS CAN BE COMPLEX AND CONFUSING, AND THEIR GOAL IS TO MAKE THE HEALTH INSURANCE ENROLLMENT PROCESS AS SIMPLE AS POSSIBLE FOR THE PATIENT. WHEN AN INDIVIDUAL OR FAMILY'S CIRCUMSTANCES CHANGE, THE ADVOCACY STAFF CAN ASSIST IN UPDATING THE APPROPRIATE AGENCY.ADVOCACY FOR ACCESS ASSISTS THOUSANDS OF PEOPLE EACH YEAR ACCESS HEALTH INSURANCE OR OTHER COVERAGE PROGRAMS TO AID THEM IN ADDRESSING THEIR HEALTHCARE NEEDS.IN ADDITION TO THE ADVOCACY FOR ACCESS PROGRAM, BERKSHIRE HEALTH SYSTEMS HAS AN INTERNAL FINANCIAL ASSISTANCE PROGRAM THAT IS AVAILABLE TO UNINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC ASSISTANCE THROUGH THE STATE OR WHO ARE NOT MASSACHUSETTS RESIDENTS.INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS IS OFFERED TO OUR PATIENTS IN THE FOLLOWING MANNER:NOTICES OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS ARE POSTED THROUGHOUT THE HOSPITAL, SPECIFICALLY IN ALL SERVICE DELIVERY AREAS, IN FINANCIAL COUNSELING OFFICES THROUGHOUT THE CLINICAL CAMPUSES, IN ALL BERKSHIRE FACULTY SERVICES PHYSICIAN PRACTICES, AND ELECTRONICALLY ON BMC'S WEBSITE WWW.BERKSHIREHEALTHSYSTEMS.ORG. APPOINTMENTS CAN BE MADE WITH THE ADVOCACY FOR ACCESS APPLICATION COUNSELORS WHO CAN ASSIST PATIENTS SUBMIT AN ELECTRONIC APPLICATION VIA WWW.MAHEALTHCONNECTOR.ORG FOR STATE FINANCIAL ASSISTANCE PROGRAMS. APPLICATION COUNSELOR ARE ALSO AVAILABLE DAILY TO MEET WITH PATIENTS WHO PRESENT AT THE OFFICE WITHOUT AN APPOINTMENT.AT PRE-REGISTRATION, SELF-PAY PATIENTS ARE OFFERED AN APPOINTMENT WITH THE ADVOCACY FOR ACCESS PROGRAM OFFICE ALONG WITH AN EXPLANATION OF THE SERVICE.BROCHURES ARE DISTRIBUTED AT ALL ACCESS POINTS INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS WITH PHONE NUMBERS TO CONTACT ADVOCACY FOR ACCESS TO SET UP AN APPOINTMENT. STATEMENTS MAILED TO PATIENTS WHO HAVE A SELF-PAY BALANCE WILL HAVE A MESSAGE INDICATING THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE AND THE PHONE NUMBERS TO CONTACT ADVOCACY FOR ACCESS FOR ADDITIONAL INFORMATION. ALL PATIENT STATEMENTS HAVE A MESSAGE ON THE BACK OF THE STATEMENT INDICATING THE AVAILABILITY OF FINANCIAL ASSISTANCE.
PART VI, LINE 4:	BERKSHIRE COUNTY IS THE MOST WESTERN OF THE 14 COUNTIES IN MASSACHUSETTS. WITH ABOUT 12% OF THE TOTAL LAND MASS IN MASSACHUSETTS, AND ONLY 2% OF THE POPULATION, BERKSHIRE COUNTY IS THE SECOND MOST RURAL COUNTY IN THE STATE. THE BERKSHIRES RUN ALONG THE NEW YORK BORDER FROM VERMONT IN THE NORTH TO CONNECTICUT IN THE SOUTH AND ENCOMPASSES MOST OF THE MOUNTAIN RIDGE THAT SEPARATES THE HUDSON AND CONNECTICUT RIVER VALLEYS. ELEVATIONS RANGE FROM 500 FEET IN THE RIVER VALLEYS TO 3500 FEET AT MOUNT GREYLOCK.THE SOCIODEMOGRAPHIC CHARACTERISTICS OF BERKSHIRE COUNTY:SEX AND AGE TOTAL POPULATION 125,927 MALE 48.5% FEMALE 51.5%MEDIAN AGE (YEARS) 47.2 YRS. UNDER 5 YEARS 4.2% 5-19 YEARS 15.7% 20-64 YEARS 56.9% 65 YEARS AND OVER 23.2%RACE AND ETHNICITY ONE RACE 96.3% WHITE 89.9% BLACK OR AFRICAN AMERICAN 2.7% AMERICAN INDIAN AND ALASKA NATIVE 0.3% ASIAN 1.7% NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER 0.0% SOME OTHER RACE 1.6%TWO OR MORE RACES 3.7%HISPANIC OR LATINO (OF ANY RACE) 5.0% NOT HISPANIC OR LATINO 95.0% NOT HISPANIC OR LATINO, WHITE ALONE 87.7%THE COUNTY IS COMPRISED OF THREE DISTINCT SUB-REGIONS: NORTH, SOUTH, AND CENTRAL WHICH FORM THE OVERALL COUNTY PROFILE OF A LARGELY RURAL AREA WITH SMALL URBAN, AGRARIAN, AND POST-INDUSTRIAL TOWNS AND CITIES. WHILE TIED TOGETHER ECONOMICALLY, SOCIALLY, AND POLITICALLY, EACH SUB-REGION REFLECTS A DEGREE OF SOCIAL AND ECONOMIC DIFFERENCES, PRIMARILY DUE TO THE 50-MILE LENGTH OF THE COUNTY FROM NORTH TO SOUTH. BERKSHIRE COUNTY'S POPULATION, ACCORDING TO THE 2020 CENSUS, IS 129,026, WITH POPULATION LARGELY CONCENTRATED IN THE COUNTY'S TWO CITIES-PITTSFIELD (43,927) AND NORTH ADAMS (12,961).SINCE THE CLOSURE OF THE FORMER NORTH ADAMS REGIONAL HOSPITAL IN 2014, BERKSHIRE MEDICAL CENTER AND BERKSHIRE HEALTH SYSTEMS STABILIZED ACCESS TO CRITICAL SERVICES FIRST AND THEN PROCEEDED TO ADD ADDITIONAL SERVICES TO MEET COMMUNITY NEED AND ACCESS EFFORTS. THIS WORK CONTINUES AND HAS BEEN SUPPORTED WITH THE HELP OF MANY LOCAL ORGANIZATIONS, ELECTED OFFICIALS, AND GOVERNMENT AGENCIES. THE BERKSHIRES IS A NATIONALLY RECOGNIZED YEAR-ROUND TOURIST DESTINATION, KNOWN FOR ITS CULTURAL OFFERINGS AND OUTDOOR RECREATION. BOASTING AWARD-WINNING ART MUSEUMS, HISTORICAL DESTINATIONS, AND THEATRES ALONGSIDE SCENIC HIKING, BIKING, AND SKIING, THE BERKSHIRES HAS BEEN A HOLIDAY DESTINATION FOR BOSTON AND NEW YORK RESIDENTS FOR HUNDREDS OF YEARS AND IS HOME TO MANY SEASONAL RESIDENTS. THE COUNTY IS TRADITIONALLY DIVIDED INTO THREE REGIONS: NORTH, CENTRAL, AND SOUTH. IT TAKES ABOUT TWO HOURS TO DRIVE FROM THE TOWN OF SHEFFIELD IN THE SOUTH TO WILLIAMSTOWN IN THE NORTH. THERE IS NO COUNTY GOVERNMENT, AND ALL LOCAL SERVICES ARE THE RESPONSIBILITY OF EACH OF THE COUNTY'S 32 TOWNS AND CITIES. THE COMMONWEALTH OF MASSACHUSETTS FUNDS A COUNTY SHERIFF'S DEPARTMENT, DISTRICT ATTORNEY'S OFFICE, THE COURT SYSTEM, AND REGISTRY OF DEEDS. EACH AREA OF THE COUNTY IS SERVICED BY A REGIONAL EMERGENCY PLANNING COMMITTEE (REPC).BERKSHIRE COUNTY'S POVERTY RATE MIRRORS THAT OF THE STATE, HOWEVER, THE COUNTY HAS A SLIGHTLY INCREASED RATE OF POVERTY AMONG MINORS (UNDER 18 YEARS OLD). MEDIAN HOUSEHOLD INCOME FOR THE REGION IS AT LEAST 25% LOWER THAN THE STATE AVERAGE.POVERTY: PERCENTAGE OF ALL PEOPLE WHOSE INCOME IN THE PAST 12 MONTHS IS BELOW THEPOVERTY LEVEL: BERKSHIRE COUNTY 9.7% MASSACHUSETTS 9.8%POVERTY UNDER 18 YEARS: BERKSHIRE COUNTY 13.9% MASSACHUSETTS 12.2%INCOME: MEDIAN HOUSEHOLD INCOME: BERKSHIRE COUNTY $62,166 MASSACHUSETTS $84,385 MEDIAN NONFAMILY INCOME: BERKSHIRE COUNTY $36,294 MASSACHUSETTS $48,876DATA SOURCE US CENSUS BUREAU,ACS 5-YEAR ESTIMATES, 2020THE EDUCATION PROFILE OF COUNTY RESIDENTS REFLECTS THE ECONOMIC AND POPULATION DEMOGRAPHIC:THE EDUCATION LEVEL OF BERKSHIRE COUNTY RESIDENTS LARGELY MIRRORS THAT OF MASSACHUSETTS, SURPASSING THE STATE IN THE PERCENTAGE OF INDIVIDUALS WHO HAVE GRADUATED FROM HIGH SCHOOL AND HAVE AT LEAST SOME COLLEGE, OR AN ASSOCIATE DEGREE. BERKSHIRE COUNTY HAS A SIGNIFICANTLY SMALLER POPULATION OF BACHELOR'S EDUCATED RESIDENTS THAN THE STATE OVERALL (35.3% VS. 44.5%)A TOTAL OF 7.5% OF INDIVIDUALS OVER THE AGE OF 5 SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THIS FIGURE HAS BEEN RISING CONSISTENTLY, INDICATING THE GROWTH OF IMMIGRANT POPULATIONS. BHS LANGUAGE SERVICE ENCOUNTERS REVEAL A SIMILAR TREND, WITH A HIGHER AVERAGE NUMBER OF REQUESTS FOR LANGUAGE SUPPORT SERVICES IN 2021.THE CONNECTION BETWEEN EDUCATION AND INCOME CAN BE A SIGNIFICANT DETERMINANT IN HEALTH STATUS, AS IT CAN RELATE TO FOOD SECURITY, HOUSING, BEHAVIORAL HEALTH CHOICES, AND GENERAL FEELING OF WELL-BEING. THE CUMULATIVE IMPACT OF THIS TRANSITION HAS HAD A SIGNIFICANT IMPACT ON THE FABRIC OF THE COMMUNITY. TRADITIONAL SUPPORT SYSTEMS OF FAMILY, SCHOOLS, AND RELIGION HAVE BEEN CHALLENGED BY THESE DEVELOPMENTS:ALCOHOL AND DRUG ABUSE ARE SIGNIFICANT ISSUES. COUNTY RESIDENTS ARE ADMITTED INTO SUBSTANCE USE TREATMENT AT A FAR GREATER RATE THAN THE STATE AVERAGE.IN 2016, SUICIDE RATES IN BERKSHIRE COUNTY WERE 11.8 AND CONTINUE TO BE HIGHER THAN THE STATE RATE OF 9.2 PER 100,000 POPULATION. (CHNA)FROM 2012 TO 2016 THE VIOLENT CRIME RATE PER 100,00 POPULATION INCREASED BY 95% IN NORTH ADAMS (705.3 TO 1375.2) AND 85.6% IN PITTSFIELD'S (425.7 TO. 790.1). HOWEVER, DURING THE SAME PERIOD MASSACHUSETTS, OVERALL, HAD A DECREASE OF 7.1% (405.5 TO 376.9). (CITY DATA)COMMUNITY PARTNERS NORTHERN BERKSHIRE COMMUNITY COALITION, THE BERKSHIRE YOUTH DEVELOPMENT PROJECT, BERKSHIRE UNITED WAY, AND THE RAILROAD STREET YOUTH PROJECT WITH THE SUPPORT OF BHS, CONDUCTED A COUNTY-WIDE PREVENTION NEEDS ASSESSMENT SURVEY IN 2021. THERE ARE SOME DIFFERENCES BETWEEN THE COUNTY, FOR EXAMPLE ALCOHOL USE IS MORE LIKELY IN CENTRAL COUNTY AND CIGARETTES ARE MORE LIKELY IN SOUTH COUNTY WHERE SUICIDAL IDEATION IS MORE LIKELY IN NORTH COUNTY. AMONG ADOLESCENTS, ALCOHOL, MARIJUANA, AND TOBACCO APPEAR TO BE THE MOST PREVALENT SUBSTANCES BEING USED. (CHNA) CONTINUED ON SCHEDULE O
PART VI, LINE 5:	THE GOVERNING BODY OF BERKSHIRE MEDICAL CENTER (BMC) CONSISTS OF COMMUNITY VOLUNTEERS, PHYSICIAN REPRESENTATIVES OF THE HOSPITALS' MEDICAL STAFF AND, AND THE CHIEF EXECUTIVE OFFICER. THE COMMUNITY VOLUNTEERS ARE ELECTED FOR TERMS OF UP TO THREE YEARS, ARE SUBJECT TO TERM LIMITS AND REPRESENT A WIDE SPECTRUM OF COMMUNITY INTERESTS-INCLUDING SOCIAL SERVICE PROVIDERS, LOCAL BUSINESS LEADERS, FINANCIAL PROFESSIONALS, CONSUMER ADVOCATES AND EDUCATIONAL LEADERS. MOST COMMITTEES OF THE BOARD OF TRUSTEES INCLUDE ADDITIONAL COMMUNITY REPRESENTATIVES. BHS MAINTAINS A PATIENT AND FAMILY COUNCIL TO PROVIDE INPUT AND ADVICE ON A WIDE RANGE OF SERVICE TOPICS.THE MEDICAL STAFF OF BHS IS OPEN TO ALL PHYSICIANS WHO MEET CLINICAL AND PATIENT SERVICE CRITERIA, ALTHOUGH CERTAIN HOSPITAL-BASED SERVICES-RADIOLOGY, ANESTHESIA, EMERGENCY DEPARTMENT AND PATHOLOGY-ARE FUNCTIONALLY CLOSED BECAUSE OF THE WAY THOSE DEPARTMENTS ARE STRUCTURED.BMC REGULARLY EXPENDS PERSONNEL AND FINANCIAL RESOURCES IN SUPPORT OF COMMUNITY INITIATIVES THAT PROMOTE IMPROVEMENTS IN COMMUNITY HEALTH AND WELL-BEING AND FOR WHICH IT DOES NOT EXPECT REIMBURSEMENT. THE HOSPITAL UTILIZES SURPLUS FUNDS FOR CAPITAL IMPROVEMENTS AND TO MAINTAIN ACCESS TO PATIENT SERVICES AND EXPAND ACCESS POINTS OF CARE AND SERVICES THAT SUPPORT COMMUNITY BENEFIT PRIORITIES TO PATIENTS THROUGHOUT THE COMMUNITY. THE BERKSHIRE COUNTY COMMUNITY HAS LONG LABORED UNDER A CRITICAL PHYSICIAN SHORTAGE IN VARIOUS SPECIALTIES AND BHS HAS IN RECENT YEARS EXPENDED SIGNIFICANT PERSONNEL TIME AND FINANCIAL RESOURCES IN RECRUITING PHYSICIANS TO THE AREA AS DIRECT EMPLOYEES OF BHS OR ITS AFFILIATES. MOREOVER, BMC HAS, IN APPROPRIATE WAYS, PROVIDED SUBSTANTIAL ASSISTANCE TO COMMUNITY MEDICAL PRACTICES TO RECRUIT AND SUPPORT THE PRACTICE START-UP OF NEW PHYSICIANS IN NEEDED SPECIALTIES. THE HEALTH SYSTEM IS ALSO FACING CRITICAL SHORTAGES IN VARIOUS AREAS OF NURSING AND HEALTHCARE. AS DISCUSSED AT GREATER LENGTH IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), BMC CONTINUALLY GOES ABOVE AND BEYOND TO SUPPORT THE HEALTH OF THE COMMUNITY THROUGH EXTENSIVE COMMUNITY OUTREACH PROGRAMS AND SUPPORT, COMPREHENSIVE, COMMUNITY-BASED INITIATIVES TO ADDRESS SUCH DIVERSE HEALTHCARE CHALLENGES AS DIABETES, HYPERTENSION AND HEART FAILURE, SMOKING CESSATION, FALLS PREVENTION, AND CHRONIC PAIN MANAGEMENT/NARCOTICS USE AND DIVERSION, AND ACCESS TO CARE.EXAMPLES OF BMC PROMOTING THE HEALTH OF THE COMMUNITY IN FY21 INCLUDES BUT IS NOT LIMITED TO:DONATED FUNDS TO COMMUNITY EVENTS, LOCAL SPORTS TEAMS, ORGANIZATIONS, AND INITIATIVESHOSTED SEVERAL COMMUNITY EVENTS INCLUDING A SUPPORT GROUPS AND COMMUNITY EDUCATION, BMC INDEPENDENCE DAY RUN, BERKSHIRES 150, FOOD SERVICE DONATION TO HOMELESS SHELTERS MEDICAL STUDENTS PROVIDING HEALTH EDUCATION AT COMMUNITY EVENTSMEMBERS OF THE WELLNESS PROGRAM AND MANAGEMENT TEAM PROVIDING BLOOD PRESSURE SCREENINGS, HEALTH EDUCATION, ENVIRONMENTAL CLEAN UPS, AND OTHER COMMUNITY VOLUNTEERISMOFFERED COMMUNITY PARTNERS FREE ACCESS TO COMMUNITY HEALTH WORKER TRAINING PROGRAMPROVIDED JOURNEY TO HEALTH, A SERIES OF CLASSES ON HEALTH AND WELLBEING WITH PRESENTATIONS DELIVERED BY DOCTORS, NURSES, DIETITIANS, AND SOCIAL WORKERSSUPPORTED A WIDE VARIETY OF COMMUNITY ORGANIZATIONS AND INITIATIVES INCLUDING HEALTH RELATED ORGANIZATIONS SUCH AS THE BRIEN CENTER (MENTAL HEALTH AND ADDICTION TREATMENT), THE ELIZABETH FREEMAN CENTER (RAPE AND SEXUAL ASSAULT SUPPORT), HILLCREST EDUCATIONAL CENTERS (EDUCATION FOR YOUTH WITH DEVELOPMENTAL DISABILITIES), AND THE DARE PROGRAM (DRUG-RESISTANCE PROGRAM FOR KIDS)SUPPORTED SIGNIFICANT COMMUNITY EDUCATIONAL AND CULTURAL INSTITUTIONS IN OUR AREA INCLUDING BERKSHIRE COMMUNITY COLLEGE, BERKSHIRE THEATRE GROUP, MASSACHUSETTS COLLEGE OF LIBERAL ARTS, THE PITTSFIELD PARADE COMMITTEE, GIRLS INC., AND COMMUNITY ACCESS TO THE ARTSASSISTED COMMUNITY AGENCIES WITH NALOXONE AND EDUCATION
PART VI, LINE 6:	BMC IS A PART OF AN INTEGRATED, NON-PROFIT HEALTHCARE SYSTEM THAT INCLUDES (A) A TEACHING HOSPITAL, (B) A CRITICAL ACCESS COMMUNITY HOSPITAL, (C) A LARGE, MULTISPECIALTY FACULTY PRACTICE ORGANIZATION, (D) A HOME HEALTH AGENCY AND (E), BY CONTRACT AND CLOSE COORDINATION, A NON-PROFIT SENIOR CARE ORGANIZATION THAT INCLUDES SUB-ACUTE SERVICES IN REHABILITATION AND LONG TERM CARE FACILITIES, ASSISTED LIVING FACILITIES, HOSPICE CARE SERVICES, SENIOR DAY CARE AND OTHER ELDERCARE SERVICES. BMC ENGAGES IN HEALTHCARE NEEDS ASSESSMENT AND PLANNING ON A SYSTEM-WIDE BASIS, WITH A GOAL OF A SEAMLESS TRANSITION OF PATIENT-CENTERED CARE ACROSS THE SPECTRUM OF SERVICES OFFERED BY EACH OF THE SYSTEM'S COMPONENT ENTITIES. BMC, ALONG WITH ITS AFFILIATES, CONTINUES TO DEVELOP INTEGRATED CLINICAL AND INFORMATION SYSTEMS ACROSS THE ENTIRE ORGANIZATION SO AS TO RENDER CARE EFFICIENTLY, EFFECTIVELY AND CONSISTENTLY AT EVERY CARE SITE. THE BMC AFFILIATES SUCH, AS THE PHYSICIAN FACULTY PRACTICE, ARE FULLY INTEGRATED INTO OUR COMMUNITY BENEFIT PROCESS AND SUPPORT THE ORGANIZATION'S PRIORITIES BY HONORING OUR FREE CARE GUIDELINES AND IN ENGAGING IN SPECIFIC PROGRAMS AND INITIATIVES DESIGNED TO MEET COMMUNITY NEED.
PART VI, LINE 7, REPORTS FILED WITH STATES	MA

Schedule H (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

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

BERKSHIRE MEDICAL CENTER INC

Employer identification number

04-2791396

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

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

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

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

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

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

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

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

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

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

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

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

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

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

Cat. No. 50053T

Schedule J (Form 990) 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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1DAVID PHELPS TRUSTEE/PRESIDENT TERM ENDED 1/1/22	(i) (ii)	0 ------------- 1,090,852	0 ------------- 0	0 ------------- 46,780	0 ------------- 13,050	0 ------------- 38,402	0 ------------- 1,189,084	0 ------------- 0
2DARLENE RODOWICZ PRESIDENT/TRUSTEE TERM BEGAN 1/1/22	(i) (ii)	0 ------------- 542,023	0 ------------- 0	0 ------------- 63,108	0 ------------- 12,083	0 ------------- 34,401	0 ------------- 651,615	0 ------------- 0
3TONY MAKDISI MD HOSPITALIST	(i) (ii)	578,514 ------------- 0	9,996 ------------- 0	2,934 ------------- 0	12,800 ------------- 0	32,674 ------------- 0	636,918 ------------- 0	0 ------------- 0
4ROBIN BURNS-LAMBERT MD ANESTHESIOLOGIST	(i) (ii)	562,286 ------------- 0	0 ------------- 0	5,471 ------------- 0	12,517 ------------- 0	32,782 ------------- 0	613,056 ------------- 0	0 ------------- 0
5RAYMOND GARY SOHL MD ANESTHESIOLOGIST	(i) (ii)	535,412 ------------- 0	0 ------------- 0	8,120 ------------- 0	8,453 ------------- 0	37,315 ------------- 0	589,300 ------------- 0	0 ------------- 0
6SEETHA MUTHAVARAPU MD HOSPITALIST	(i) (ii)	504,277 ------------- 0	8,871 ------------- 0	2,766 ------------- 0	13,050 ------------- 0	32,733 ------------- 0	561,697 ------------- 0	0 ------------- 0
7BARANI MAYIL VAGANAN MD GASTROENTEROLOGIST	(i) (ii)	464,055 ------------- 0	47,345 ------------- 0	2,308 ------------- 0	13,050 ------------- 0	26,650 ------------- 0	553,408 ------------- 0	0 ------------- 0
8MICHAEL MCHUGH MD CHAIRMAN-E.D. MEDICINE	(i) (ii)	420,735 ------------- 0	65,041 ------------- 0	16,679 ------------- 0	13,050 ------------- 0	33,679 ------------- 0	549,184 ------------- 0	0 ------------- 0
9ANDREW MANZER CHIEF OPERATING OFFICE	(i) (ii)	451,448 ------------- 0	0 ------------- 0	51,127 ------------- 0	12,275 ------------- 0	30,552 ------------- 0	545,402 ------------- 0	0 ------------- 0
10SCOTT ST GEORGE TREASURER	(i) (ii)	0 ------------- 480,696	0 ------------- 0	0 ------------- 37,308	0 ------------- 895	0 ------------- 10,744	0 ------------- 529,643	0 ------------- 0
11ALEC R BELMAN MD TRUSTEE/PHYSICIAN TERM BEGAN 1/22	(i) (ii)	0 ------------- 347,321	0 ------------- 16,696	0 ------------- 2,637	0 ------------- 13,050	0 ------------- 37,267	0 ------------- 416,971	0 ------------- 0
12MICHAEL MCINERNEY MD TRUSTEE/PHYSICIAN TERM ENDED 12/21	(i) (ii)	0 ------------- 265,072	0 ------------- 21,779	0 ------------- 6,982	0 ------------- 10,724	0 ------------- 33,340	0 ------------- 337,897	0 ------------- 0
13BRIAN BURKE MD TRUSTEE/PHYSICIAN TERM END 12/21	(i) (ii)	0 ------------- 191,950	0 ------------- 0	0 ------------- 5,571	0 ------------- 8,955	0 ------------- 27,098	0 ------------- 233,574	0 ------------- 0
14EDMUND HORNSTEIN DO TRUSTEE	(i) (ii)	0 ------------- 0	0 ------------- 0	192,314 ------------- 0	0 ------------- 0	0 ------------- 0	192,314 ------------- 0	0 ------------- 0

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 II

IN REFERENCE TO FORM 990, PART VII AND SCHEDULE J PART II, NO COMPENSATION IS PAID BY THE FILING ENTITY TO ANY DIRECTOR (TRUSTEE) FOR HIS OR HER ROLE AS DIRECTOR (TRUSTEE). THE OFFICERS OF THE FILING ENTITY ARE COMPENSATED FOR THEIR ROLES AS OFFICERS. PHYSICIANS WHO SERVE AS DIRECTOR (TRUSTEE) ARE COMPENSATED FOR THEIR ROLES AS PHYSICIANS. COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY THE INDEPENDENT VOLUNTEER GOVERNING BODY OF BERKSHIRE HEALTH SYSTEMS, INC. (PARENT ORGANIZATION OF THE FILING ENTITY), BASED ON PERFORMANCE REVIEWS AND COMPARISON TO INDEPENDENTLY ESTABLISHED, REGIONALLY APPROPRIATE BENCHMARKS FOR SIMILAR POSITIONS IN SIMILARLY SIZED HEALTHCARE ORGANIZATIONS, AS VERIFIED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS SET IN ACCORDANCE WITH GOVERNING-BODY ESTABLISHED PRINCIPLES BASED ON COMPARABLE BENCHMARK IDENTIFIED BY SUCH INDEPENDENT CONSULTANTS. IN THE REPORTING YEAR, THE GOVERNING BODY TARGETED TOTAL COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 60TH PERCENTILE OF APPROPRIATE.

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

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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
BERKSHIRE MEDICAL CENTER INC

Employer identification number
04-2791396

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MDFA BHS SERIES I	04-3431814	57584YP94	08-03-2021	58,923,326	REFUND SERIES G BONDS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	58,923,326
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	844,443
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	58,078,883
12 Other unspent proceeds .............
13 Year of substantial completion .............	2021
	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
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
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
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 .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		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
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

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X
b Exception to rebate? ........		X
c No rebate due? .........		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

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
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
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
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) 2021

Additional Data

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

BERKSHIRE MEDICAL CENTER INC

Employer identification number

04-2791396

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	1	99,660	FAIR MARKET VLAUE
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2021)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
PART I, COLUMN (B):	ORGANIZATION RECEIVED ONE CONTRIBUTION OF PUBLICLY TRADED STOCK.

Schedule M (Form 990) (2021)

Additional Data

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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

BERKSHIRE MEDICAL CENTER INC

Employer identification number

04-2791396

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	BERKSHIRE HEALTH SYSTEMS, INC. IS THE SOLE CORPORATE MEMBER OF BERKSHIRE MEDICAL CENTER, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THE BOARD OF TRUSTEES IS COMPOSED OF THE INCUMBENT MEMBERS OF THE BOARD OF TRUSTEES OF BERKSHIRE HEALTH SYSTEMS, INC.
FORM 990, PART VI, SECTION B, LINE 11B	BHS WILL MAKE THE FORMS 990 FOR BHS AND AFFILIATES AVAILABLE TO THE MEMBERS OF THE RESPECTIVE GOVERNING BODIES FOR THEIR REVIEW BY (A) SENDING COPIES TO THEM PHYSICALLY OR ELECTRONICALLY, OR (B) NOTIFYING THE MEMBERS THAT THE FORMS 990 CAN BE ACCESSED BY A SECURE WEB-BASED FOLDER BEFORE THEY ARE FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION MONITORS AND ENFORCES ITS CONFLICT OF INTEREST POLICY BY REQUIRING ALL MEMBERS OF THE GOVERNING BODY AND ALL OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST (A) ANNUALLY AND (B) AS POTENTIAL CONFLICTS ARISE. THE EXECUTIVE COMMITTEE OF THE GOVERNING BODY IS CHARGED WITH REVIEWING POTENTIAL CONFLICTS OF INTEREST INVOLVING MEMBERS OF THE GOVERNING BODY OR THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION. THE PRESIDENT AND CHIEF EXECUTIVE OFFICER IS CHARGED WITH REVIEWING POTENTIAL CONFLICTS OF INTEREST INVOLVING ANY OTHERS. OFFICERS (INCLUDING THE PRESIDENT AND CHIEF EXECUTIVE OFFICER), KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES ARE NOT PERMITTED TO HAVE MATERIAL CONFLICTS OF INTEREST. THE DISINTERESTED MEMBERS OF THE GOVERNING BODY ARE CHARGED WITH DETERMINING WHETHER A CONFLICT EXISTS IN THE CASE OF MEMBERS OF THE GOVERNING BODY AND HOW THE AFFECTED MEMBER IS TO ABSTAIN FROM ACTION THAT MAY BE INFLUENCED BY HIS OR HER CONFLICT OR POTENTIAL CONFLICT, INCLUDING BY (A) NOT VOTING OR (B) NOT VOTING AND LEAVING THE ROOM OR (C) LEAVING THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION OF THE CHIEF EXECUTIVE OFFICER IS REVIEWED AND ESTABLISHED AT LEAST BIANNUALLY BY THE INDEPENDENT, VOLUNTEER, BHS GOVERNING BODY, BASED ON PERFORMANCE REVIEWS AND COMPARISON TO INDEPENDENTLY ESTABLISHED, REGIONALLY APPROPRIATE BENCHMARKS FOR SIMILAR POSITIONS IN SIMILARLY SIZED HEALTHCARE ORGANIZATIONS, AS VERIFIED BY INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS SET IN ACCORDANCE WITH GOVERNING BODY-ESTABLISHED PRINCIPLES BASED ON COMPARABLE BENCHMARK IDENTIFIED BY SUCH INDEPENDENT CONSULTANTS. IN THE REPORTING YEAR, THE GOVERNING BODY TARGETED TOTAL COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 60TH PERCENTILE OF APPROPRIATE BENCHMARKS. THE ORGANIZATION FOLLOWED THIS PROCESS FOR THE TAX YEAR BEING REPORTED.
FORM 990, PART VI, SECTION C, LINE 18	BERKSHIRE MEDICAL CENTER, INC'S FORM 990 REPORT IS AVAILABLE ON THE FOLLOWING WEBSITES: GUIDESTAR AT WWW.GUIDESTAR.ORG OFFICE OF THE MA ATTORENY GENERAL AT WWW.CHARITIES.AGO.STATE.MA.US/CHARITIES/
FORM 990, PART VI, SECTION C, LINE 19	GOVERNANCE DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AT THE OFFICE OF (A) THE CHIEF FINANCIAL OFFICER AND (B) THE VICE PRESIDENT AND GENERAL COUNSEL AT 725 NORTH STREET, PITTSFIELD MA 01201.
FORM 990, PART XI, LINE 9:	EQUITY TRANSFER -25,439,663.
SCHEDULE H PART V SECTION B LINE 5	CHRONIC CONDITIONS CHRONIC HEALTH CONDITIONS REMAIN PRIORITIZED NEEDS. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), CARDIOVASCULAR DISEASE, AND OTHER CHRONIC CONDITIONS THAT ARE ALSO RISK FACTORS FOR HEART DISEASE - DIABETES AND OBESITY - ALSO SHOW DISPARITIES, WITH HIGHER RATES AMONG BLACK RESIDENTS. ANOTHER CHRONIC CONDITION, ALZHEIMER'S DISEASE, APPEARS TO HAVE BEEN AFFECTED BY COVID-19, WITH THE U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) REPORTING THAT THERE WERE 16% MORE DEATHS FROM THIS AND OTHER FORMS OF DEMENTIA IN 2020 COMPARED TO THE PRIOR FIVE-YEAR AVERAGE. CANCER HOSPITAL ADMISSION RATES DECREASED ACROSS THE SERVICE AREA. THE SERVICE AREA SAW AN INCREASE IN RESIDENTS AGED 65 AND OLDER LIVING IN THE AREA, AND ADVANCED AGE (65 AND OLDER) IS A RISK FACTOR FOR CANCER. ACCESS TO PHYSICAL ACTIVITY AND A HEALTHY DIET CONTRIBUTE TO HEALTH AND WELL-BEING, AND YOUTH AND ADULTS ARE NOT GETTING THE RECOMMENDED INTAKE OF FRUITS AND VEGETABLES AND LEISURE-TIME PHYSICAL ACTIVITY. BERKSHIRE COUNTY HAS THE HIGHEST RATE OF PREMATURE DEATH UNDER AGE 75 IN MASSACHUSETTS, WITH BLACK RESIDENTS IN BERKSHIRE COUNTY DISPROPORTIONATELY IMPACTED BY PREMATURE DEATH. HOUSING AND HOMELESSNESS AFFORDABLE, ACCESSIBLE, AND SUPPORTIVE HOUSING IS A KEY CONTRIBUTOR TO HEALTH, AND COVID-19 HAS CONTRIBUTED TO HOUSING CHALLENGES. SEVERAL KEY INFORMANT INTERVIEWS FOR THIS REPORT IDENTIFIED SAFE AND AFFORDABLE HOUSING AS ONE OF THE TOP HEALTH-RELATED CONCERNS. MORE THAN ONE IN FOUR (26%) OF HOUSEHOLDS IN THE SERVICE AREA QUALIFY AS HOUSING-COST BURDENED, MEANING THEY SPEND 30% OR MORE OF THEIR INCOME ON HOUSING. UNAFFORDABLE HOUSING CORRELATES WITH A GREATER-THAN-AVERAGE PREVALENCE OF HOMELESSNESS - A SITUATION THAT HAS WORSENED OVER THE PAST DECADE. THE PANDEMIC HAS CORRELATED WITH A GENERAL INCREASE IN HOUSING PRICES THAT HAS MOVED HOMEOWNERSHIP - A COMMON VEHICLE FOR WEALTH-GENERATION - OUT OF REACH FOR MANY. THE SHORT-TERM MIGRATION OF NEW YORK AND BOSTON RESIDENTS TO THE COUNTY TO ESCAPE THE PANDEMIC FURTHER IMPACTED HOUSING AFFORDABILITY AND ACCESS. A RECENT RISE IN INTEREST RATES HAS MADE HOMEOWNERSHIP EVEN LESS ATTAINABLE. TRANSPORTATION AFTER HOUSING, TRANSPORTATION WAS THE SECOND MOST PRESSING ISSUE IDENTIFIED BY KEY INFORMANTS AND PUBLIC HEALTH OFFICIALS IN BERKSHIRE COUNTY. RELIABLE TRANSPORTATION IS A CRITICAL PART OF DAILY LIFE, ALLOWING INDIVIDUALS TO GO TO WORK, TRAVEL TO THE GROCERY STORE, AND GET TO MEDICAL APPOINTMENTS. TRANSPORTATION TO GET TO MEDICAL APPOINTMENTS IS A PARTICULARLY DIFFICULT ISSUE FOR CHILDREN AND ADULTS LIVING WITH DISABILITIES, OLDER ADULTS, AND LIMITED-INCOME POPULATIONS. APPROXIMATELY ONE IN TEN (9%) OF SERVICE AREA RESIDENTS REPORT NOT HAVING ANY ACCESS TO A VEHICLE. THE COVID-19 PANDEMIC EXACERBATED PROBLEMS OF ACCESS TO TRANSPORTATION. ACCORDING TO A REPORT BY THE BUREAU OF LABOR STATISTICS, THE PRICE OF USED CARS INCREASED BY 41% IN THE 12 MONTHS BETWEEN JANUARY 2021 AND JANUARY 2022. FUEL COSTS HAVE INCREASED BY 47% OVER THE SAME INTERVAL. THIS MEANS THAT RELIABLE TRANSPORTATION HAS BECOME LESS AFFORDABLE FOR MANY. PRIORITY POPULATIONS THIS CHNA IDENTIFIED MANY INEQUITIES IN PRIORITIZED HEALTH NEEDS AMONG YOUTH, OLDER ADULTS, AND MEDICALLY UNDERSERVED INDIVIDUALS. ALSO, THOSE WHO ARE BLACK OR LATINO/A/E EXPERIENCE FURTHER INEQUITIES, AS THEY OR THEIR FAMILIES HAVE A LOWER MEDIAN INCOME THAN WHITE RESIDENTS, MAKING IT HARDER FOR THEM TO AFFORD BASIC NEEDS AND TO ACCESS QUALITY HEALTH CARE. THEY ALSO EXPERIENCE FRAGMENTATION OF CARE, INDIVIDUAL AND SYSTEMIC RACISM WITHIN HEALTH CARE INSTITUTIONS, AND LACK OF CARE THAT IS CULTURALLY AND LINGUISTICALLY APPROPRIATE. THE PANDEMIC EXACERBATED EXISTING INEQUITIES. THERE WERE HIGHER RATES OF INFECTION AND DEATH IN BERKSHIRE COUNTY RELATIVE TO SOME OF THE OTHER WESTERN MASSACHUSETTS COUNTIES. NATIONAL TRENDS INDICATE THAT OLDER ADULTS, COMMUNITIES OF COLOR, AND THOSE WITH LIMITED MEANS SUFFERED HIGHER RATES OF BOTH INFECTION AND DEATH. BASED ON NATIONAL STUDIES, THE PANDEMIC-INDUCED UPHEAVAL IN THE ECONOMY AND THE SHIFT TO REMOTE SCHOOLING DISPROPORTIONATELY HARMED WOMEN OF COLOR AND CAUSED DISRUPTIONS IN EDUCATION FOR YOUTH. THE PANDEMIC ALSO HAD SIGNIFICANT EFFECTS ON MENTAL HEALTH. LGBTQIA+ YOUTH, YOUTH WITH DISABILITIES, AND OLDER ADULTS EXPERIENCED HIGH RATES OF DEPRESSION AND ANXIETY DURING COVID-19 COMPARED TO OTHER GROUPS. MEDICALLY UNDERSERVED INDIVIDUALS EXPERIENCE COMPLEX HEALTH NEEDS THAT OFTEN HAVE ROOTS IN SYSTEMIC BARRIERS. THESE INCLUDE HIGH RATES OF SUBSTANCE USE, MENTAL ILLNESS, CHRONIC DISEASE, AND INFECTIOUS DISEASE - WHICH OFTEN CO-OCCUR. THIS POPULATION IS DISPROPORTIONATELY COMPOSED OF PEOPLE WITH LIMITED INCOMES, IMMIGRANTS, AND INDIVIDUALS OF COLOR. IMMIGRANTS WERE ALSO AT GREATER RISK FOR COVID-19 INFECTION AND DEATH. ADDITIONALLY, THEY FACE BARRIERS DUE TO THE STIGMA ASSOCIATED WITH BEING AN IMMIGRANT, AND DISCRIMINATION IN ACCESSING HOUSING AND EMPLOYMENT. IN SUM, FOR SO MANY FACETS OF HEALTH AND HEALTH CARE, COVID-19 DEEPENED INEQUITIES. VIRTUALLY EVERY PRIORITIZED HEALTH NEED WAS AFFECTED BY THE PANDEMIC, AND PEOPLE WITH ONE OR MORE MARGINALIZED IDENTITIES OFTEN FELT THE COMPOUNDING EFFECTS.
SCHEDULE H, PART V SECTION B LINE 11	OBESITY - BERKSHIRE MEDICAL CENTER HAS SEVERAL PROGRAMS FOCUSED ON REDUCING OBESITY AMONG BOTH YOUTH AND ADULT POPULATIONS. OPERATION BETTER START (OBS) IS A UNIQUE PROGRAM THAT WORKS WITH FAMILIES AND CHILDREN TO PROVIDE NUTRITIONAL GUIDANCE AND EXERCISE PROGRAMS. OBS PARTNERS WITH LOCAL PEDIATRICIANS AND THE PUBLIC SCHOOLS TO REACH AT RISK YOUTH AND FAMILIES. BMC WELLNESS AT WORK PROVIDES LOCAL BUSINESSES WITH TARGETED WELLNESS PROGRAMS FOR EMPLOYEES TO REDUCE OBESITY AND OTHER CO-MORBIDITIES. TOBACCO USE/ NICOTINE DEPENDENCE- THIS NEED IS ADDRESSED BY BMC THROUGH "HYPNOSIS FOR QUITTING SMOKING", BEAT THE PACK (OFFERED TO EMPLOYEES), TOBACCO CESSATION EDUCATION AND, REFERRALS TO OTHER TOBACCO CESSATION PROGRAMS. ADDITIONALLY, OTHER COMMUNITY ORGANIZATIONS AND PROGRAMS THAT ARE ON THE FOREFRONT OF ADDRESSING THIS NEED INCLUDE: BERKSHIRE AHEC, TRI-TOWN HEALTH DEPARTMENT, MAKE SMOKING HISTORY THROUGH MASSACHUSETTS DPH, AND QUIT TO WIN THROUGH FALLON HEALTH. BMC REFERS TO THESE PROGRAMS FOR TOBACCO AND NICOTINE CESSATION EFFORTS. ACCESS TO CARE ACCESS FOR UNDER AND UNINSURED - BMC'S ADVOCACY FOR ACCESS PROGRAM CONNECTS THOUSANDS OF PEOPLE IN OUR COMMUNITY TO HEALTH INSURANCE OPTIONS AVAILABLE THROUGH MASSHEALTH AND OTHER PROGRAMS. ENHANCING ACCESS AND THE HEALTHCARE WORKFORCE - THE REGION'S SIGNIFICANT RELIANCE ON GOVERNMENT-REIMBURSED SERVICES CAN HAVE A DIRECT INFLUENCE ON LOCALLY AVAILABLE PROGRAMS AND SERVICES. BHS CONTINUES TO FACE STAFFING CHALLENGES, LIKE THOSE EXPERIENCED ACROSS THE NATION AND IS EXPLORING CAREER TRAINING PROGRAMS THAT CAN SIMULTANEOUSLY HELP TO REDUCE CLINICIAN SHORTAGES AND HELP TO RAISE MEDIAN INCOME LEVELS THROUGH STRONG EMPLOYMENT OPPORTUNITIES FOR BERKSHIRE RESIDENTS. SOCIAL ECONOMIC COMMUNITY DEVELOPMENT/ ENGAGEMENT - BMC WORKS IN COLLABORATION WITH NUMEROUS COMMUNITY ORGANIZATIONS ON PROGRAMS THAT ARE AIMED AT IMPROVING COMMUNITY DEVELOPMENT, SOME OF OUR PARTNERS INCLUDE: NORTHERN BERKSHIRE COMMUNITY COALITION, THE BERKSHIRE UNITED WAY, LOCAL SENIOR CENTERS, CITY GOVERNMENT IN PITTSFIELD AND NORTH ADAMS, AND MORE. EMERGENCY PREPAREDNESS - WORKING IN PARTNERSHIP WITH COMMUNITY ORGANIZATIONS, INCLUDING LOCAL FIRE AND POLICE DEPARTMENTS, EMS PROVIDERS, REGIONAL EMERGENCY RESPONSE COMMITTEES AND THE COUNTY BOARDS OF HEALTH ASSOCIATION, BMC HAS A COMPREHENSIVE EMERGENCY PREPAREDNESS PROGRAM. THIS PROGRAM WORKS TO IMPROVE RESPONSE TO POTENTIAL COMMUNITY EMERGENCIES THROUGH REGULAR TABLETOP AND LIVE-ACTION DRILLS. BMC'S EMERGENCY OPERATIONS ALSO HAS PLANS IN PLACE FOR RESPONSE TO A WIDE VARIETY OF POTENTIAL EMERGENCIES, INCLUDING MASS CASUALTY, ELECTRICAL OUTAGES, FLOODING, SNOW/ICE STORM, AND MANY OTHERS. HEALTHCARE DISPARITIES - BMC ACTIVELY WORKS TO REDUCE HEALTH DISPARITIES IN THE COMMUNITY THROUGH EXPANDED ACCESS TO PRIMARY CARE AND SPECIALTY SERVICES, RECRUITMENT OF HEALTHCARE PROFESSIONALS WITH VARIED BACKGROUNDS AND LANGUAGE COMPETENCY, AND A DEDICATED TRANSLATION SERVICE THAT CAN PROVIDE PATIENTS WITH ACCESS TO CARE USING THEIR OWN LANGUAGE, WITH PROFESSIONAL HEALTH INTERPRETERS AND/OR ACCESS TO ELECTRONIC SERVICES THAT CAN PROVIDE INTERPRETATION. NUMEROUS COMMUNITY EFFORTS ARE ALSO USED TO REACH AS MANY AS POSSIBLE IN THE COMMUNITY, INCLUDING COMMUNITY HEALTH WORKERS THAT CAN HELP COMMUNITY MEMBERS OVERCOME BARRIERS SUCH AS TRANSPORTATION, FOOD INSECURITY, HOUSING, TELEPHONE ACCESS, AND MUCH MORE. MATERNAL/CHILD HEALTH - BMC HAS NUMEROUS PROGRAMS DESIGNED TO AID NEW MOTHERS AND NEWBORNS IN ATTAINING OPTIMAL HEALTH DURING AND AFTER PREGNANCY, INCLUDING PRE-NATAL CLASSES AND CLASSES FOR NEW PARENTS. IN ADDITION, THE BERKSHIRE NORTH WOMEN, INFANTS, AND CHILDREN'S PROGRAM, OPERATED BY BMC, PROVIDES ACCESS TO NUTRITIONAL SERVICES AND HEALTHY FOOD OPTIONS, AND OPERATION BETTER START PROVIDES FAMILY SERVICES THAT CAN HELP THE NEWBORN AND FAMILY TO MAINTAIN A HEALTHY LIFESTYLE. SAFETY/ VIOLENCE PREVENTION -BMC SECURITY COLLABORATES WITH MANY COMMUNITY AGENCIES ON SUBSTANCE ABUSE PREVENTION AND TREATMENT AND WORKS REGULARLY WITH AREA POLICE DEPARTMENTS AS WELL AS THE BERKSHIRE COUNTY HOUSE OF CORRECTION TO ENSURE SAFETY OF THE HOSPITAL ENVIRONMENT AND THE SURROUNDING COMMUNITY. SOCIAL DETERMINANTS OF HEALTH- BMC UNDERSTANDS THAT SOCIOECONOMIC STATUS, EDUCATION, EMPLOYMENT, HOUSING, FOOD SECURITY, TRANSPORTATION AND SOCIAL PROTECTIVE FACTORS, ALL HAVE AN IMPACT ON THE PHYSICAL AND MENTAL WELLBEING OF THE POPULATION, INCLUDING THE CIRCUMSTANCES PEOPLE FIND THEMSELVES IN, AND IN MANY CASES THE LIFE CHOICES THEY MAKE OR ARE FORCED TO MAKE DUE TO SOCIAL OR ENVIRONMENTAL CONDITIONS. MANY OF BERKSHIRE COUNTY'S COMMUNITY ORGANIZATIONS DO AN OUTSTANDING JOB AT ADDRESSING THESE NEEDS ALREADY. BMC COLLABORATES WITH THESE ORGANIZATIONS AND HAS PLANS TO INCREASE PARTNERSHIP OVER THE NEXT YEAR TO FURTHER REDUCE SDOH BARRIERS. BERKSHIRE HEALTH SYSTEMS RECEIVED FUNDING FROM MA HEALTH TO PROVIDE EMERGENCY FOOD TO FACING FOOD ACCESS DIFFICULTIES OR INSECURITY DURING THE COVID-19 PANDEMIC AND DEVELOPED A GROCERY DELIVERY PROGRAM (GDP). IN 2021, THE GROCERY DELIVERY PROGRAM HAS CONTINUED AS A FLEXIBLE SERVICES PROGRAM. THE MTM AND GDP ARE OPERATIONALIZED IN COLLABORATION WITH THE BERKSHIRE COUNTY HOUSE OF CORRECTION. ADOLESCENT AND YOUTH PREGNANCY - BERKSHIRE UNITED WAY TAKES THE LEAD ON EFFORTS TO PROVIDE INFORMATIONAL AND EDUCATIONAL PROGRAMS TO YOUTH AND ADOLESCENTS TO REDUCE THE RATE OF PREGNANCY IN TEENS. BERKSHIRE MEDICAL CENTER WORKS IN COLLABORATION WITH THIS COMMUNITY PARTNER BY PARTICIPATING ON COMMITTEES, SHARING DATA, AND RESOURCES. WORKFORCE DEVELOPMENT ACCESS TO MEDICAL PROFESSIONALS - BMC HAS AN INTENSIVE PHYSICIAN AND PROVIDER RECRUITMENT PROGRAM, WHICH HAS SUCCEEDED IN SEVERAL PROFESSIONALS TO THE REGION YEARLY, PARTICULARLY IN AREAS OF CRITICAL NEED, SUCH AS: PRIMARY CARE, NEUROSURGERY AND NEUROLOGY, ORTHOPEDIC SURGERY, ENDOCRINOLOGY, AND OTHERS. THIS INCLUDES NOT ONLY PHYSICIANS, BUT ALSO NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS. TRAININGS FOR HEALTHCARE PROFESSIONALS, ALLIED HEALTHCARE WORKERS AND COMMUNITY HEALTH WORKERS- BMC SUPPORTS ITS EMPLOYEES TO ATTEND TRAININGS AND CERTIFICATIONS IN APPLICABLE AREAS, EXAMPLES OF THESE TRAININGS INCLUDE BRIDGES OUT OF POVERTY, COMMUNITY HEALTH WORKER CERTIFICATION, MENTAL HEALTH FIRST AID, MEDICAL ASSISTANT TRAINING, PHLEBOTOMY CERTIFICATION ETC. BY INVESTING IN OUR EMPLOYEES AND SUPPORTING OUR PARTNERS WE CAN BETTER SERVE THE NEEDS OF OUR COMMUNITY AT LARGE.
SCHEDULE H, PART VI LINE 4	COMMUNITY INFORMATION CONTINUED: IN MASSACHUSETTS, THE RISK FOR SUICIDE MORTALITY AND MORBIDITY VARIES SIGNIFICANTLY BY REGION. MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH IDENTIFIED BERKSHIRE COUNTY AS A REGION WITH YOUTH SUICIDE RATES/SUICIDAL BEHAVIORS INCLUDING RATES OF NON-FATAL SELF-INFLICTED INJURY HIGHER THAN THOSE IN THE STATE AND NATION. YOUTH BEHAVIOR NORTH 2021(N=482) CENTRAL 2021(N=831) SOUTH 2021(N=314) ALCOHOL USE 31.50% 37.50% 36.90% CIGARETTE USE 6.80% 9.30% 10.10% E-CIGARETTE USE 22.00% 26.10% 17.20% MARIJUANA USE 21.00% 27.30% 17.30% PLANNED SUICIDE IN LAST 12 MONTHS 17.20% 14.10% 15.20% ATTEMPTED SUICIDE IN LAST 12 MONTHS 7.70% 10.40% 8.00% DATA SOURCE: BERKSHIRE COUNTY PREVENTION NEEDS ASSESSMENT, 2021 OPIOIDS AND PRESCRIPTION DRUGS OVER THE PAST SEVERAL YEARS, USE OF DRUGS, PARTICULARLY OPIOIDS AND PRESCRIPTION DRUGS HAS EMERGED AS A GROWING BEHAVIORAL HEALTH ISSUE. BETWEEN 2010 AND 2020, THE NUMBER OF OPIOID-RELATED OVERDOSE DEATHS IN THE COUNTY INCREASED FROM 4 TO 56, A DRAMATIC SPIKE OF NEARLY 200%. OPIOID USAGE APPEARS TO BE MORE PREVALENT IN THE CENTRAL AND NORTHERN REGIONS OF BERKSHIRE COUNTY, AS EVIDENCED BY A HIGHER OVERDOSE RATE IN THOSE REGIONS. (HTTPS://WWW.MASS.GOV/DOC/OPIOID-RELATED-OVERDOSE-DEATHS -BY-COUNTY-NOVEMBER-2021/DOWNLOAD) IN AN ATTEMPT, TO AIDE IN THE REDUCTION OF OPIOID-RELATED OVERDOSE DEATHS MANY LOCAL PHARMACIES ARE CARRYING NASAL NARCAN THAT CAN BE PROVIDED WITHOUT A PHYSICIAN'S PRESCRIPTION. ADDITIONALLY, PATIENTS OR THEIR FRIENDS OR FAMILY WHO ARE BROUGHT TO ANY OF THE BERKSHIRE COUNTY EMERGENCY DEPARTMENT WITH AN OPIOID OVERDOSE ARE PROVIDED WITH NASAL NARCAN UPON DISCHARGE INFANT AND PERINATAL CARE AND CONTROLLED SUBSTANCES AS OPIOID USE HAS INCREASED IN OUR COMMUNITY, SO HAS THE USE OF OPIOIDS IN WOMEN OF CHILD-BEARING AGE. BABIES BORN TO MOTHERS WHO HAVE USED OPIOIDS DURING PREGNANCY ARE AT RISK FOR NEONATAL ABSTINENCE OR WITHDRAWAL, WHICH CAN HAVE BOTH SHORT-TERM AND LONG-TERM SIDE EFFECTS. ALTHOUGH RATES DECREASED BETWEEN 2020 AND 2021, BERKSHIRE COUNTY STILL HAD THE SECOND-HIGHEST RATE OF MOTHERS WHO USED OPIOIDS DURING PREGNANCY AND THE SECOND-HIGHEST RATE OF BABIES BORN WITHDRAWING FROM OPIOIDS IN THE STATE OF MASSACHUSETTS. IN BRISTOL COUNTY, MOTHERS WHO USED OPIOIDS OR BENZODIAZEPINES DURING PREGNANCY DECREASED 22% BETWEEN 2020 AND THE FIRST EIGHT MONTHS OF 2021 (FROM 11.2% TO 8.7%). IN BERKSHIRE COUNTY, THE HIGHEST RATE OF MOTHERS WHO USED OPIOIDS OR BENZODIAZEPINES DURING PREGNANCY DECREASED 53% (FROM 7.9% TO 3.7%). HTTPS://WWW.MASS.GOV/DOC/NEWBORN-AND-MATERNAL-SUBSTANCE-EXPOSURE -SURVEILLANCE-NOVEMBER-2021/DOWNLOAD) COVID-19 IN BERKSHIRE COUNTY: ON MARCH 6, 2020, BERKSHIRE MEDICAL CENTER REPORTED THE FIRST INPATIENT CASE OF COVID-19 IN THE COMMONWEALTH OF MASSACHUSETTS. SINCE THEN, BHS HAS BEEN ON THE LEADING EDGE OF COVID RESPONSE FOR TESTING, TREATMENT, AND VACCINATION, WORKING QUICKLY AND EFFICIENTLY TO SUPPORT THE NEEDS OF THE BERKSHIRE COMMUNITY DURING THE ONGOING PUBLIC HEALTH EMERGENCY. IN 2020, BERKSHIRE HEALTH SYSTEMS ESTABLISHED A COVID CALL CENTER AND OPENED OUTDOOR TESTING SITES IN NORTH ADAMS, PITTSFIELD, AND GREAT BARRINGTON. IN 2021 BHS OPENED PERMANENT TESTING SITES IN NORTH ADAMS, PITTSFIELD, AND GREAT BARRINGTON AND BEGAN PROVIDING COVID-19 VACCINATIONS AT ALL THREE OF THESE SITES. IN ADDITION TO OUR STAND-ALONE SERVICES, BHS WORKED WITH THE BERKSHIRE VACCINE COLLABORATIVE TO VACCINATE TENS OF THOUSANDS OF COMMUNITY MEMBERS THROUGH LARGE-SCALE PUBLIC HEALTH CLINICS. 2019 COUNTY HEALTH RANKINGS THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE AND THE ROBERT WOOD JOHNSON FOUNDATION DEVELOPED THE "COUNTY HEALTH RANKINGS" TO HELP COMMUNITIES UNDERSTAND WHAT INFLUENCES HOW HEALTHY RESIDENTS ARE AND HOW LONG THEY WILL LIVE. THE RANKINGS LOOK AT A VARIETY OF MEASURES THAT AFFECT HEALTH SUCH AS THE RATE OF PEOPLE DYING BEFORE AGE 75, HIGH SCHOOL GRADUATION RATES, ACCESS TO HEALTHIER FOODS, AIR POLLUTION LEVELS, INCOME, RATES OF SMOKING, OBESITY AND TEEN BIRTHS. COUNTIES IN EACH OF THE 50 STATES ARE RANKED ACCORDING TO SUMMARIES OF A VARIETY OF HEALTH MEASURES. THOSE HAVING HIGH RANKS, E.G., 1 OR 2, ARE CONSIDERED TO BE THE "HEALTHIEST." COUNTIES ARE RANKED RELATIVE TO THE HEALTH OF OTHER COUNTIES IN THE SAME STATE ON THE FOLLOWING SUMMARY MEASURES: SUMMARY HEALTH OUTCOMES & HEALTH FACTORS RANKINGS COUNTIES RECEIVE TWO SUMMARY RANKS: 1. HEALTH OUTCOMES: RANKINGS ARE BASED ON AN EQUAL WEIGHTING OF ONE LENGTH OF LIFE MEASURE (MORTALITY) AND FOUR QUALITIES OF LIFE MEASURES (MORBIDITY). 2. HEALTH FACTORS: RANKINGS ARE BASED ON WEIGHTED SCORES OF FOUR TYPES OF FACTORS: I. HEALTH BEHAVIORS II. CLINICAL CARE III. SOCIAL AND ECONOMIC IV. PHYSICAL ENVIRONMENT OUT OF THE FOURTEEN COUNTIES OF MASSACHUSETTS, BERKSHIRE COUNTY RANKED: * HEALTH OUTCOMES: 13TH * HEALTH FACTORS: 11TH * HEALTH BEHAVIORS: 8TH * CLINICAL CARE: 5TH * SOCIAL AND ECONOMIC: 11TH * PHYSICAL ENVIRONMENT: 12TH WORKSITE WELLNESS PROGRAM: THE BERKSHIRE HEALTH SYSTEMS (BHS) WORKSITE WELLNESS PROGRAM IS A COMPREHENSIVE PROGRAM DEVELOPED FOR BHS EMPLOYEES, SPOUSES AND COMMUNITY AT LARGE. THE PROGRAM PROVIDES HEALTH RISK ANALYSES, SCREENINGS AND A RANGE OF PROGRAMS TO SUPPORT HEALTHY LIFESTYLES AND TO HELP REDUCE HEALTH COVERAGE COSTS THROUGHOUT BERKSHIRE COUNTY. THE WELLNESS INTEGRATIVE MODEL FOCUSES ON CREATING POSITIVE, SUSTAINABLE LIFESTYLE CHANGE BY FOSTERING PHYSICAL, MENTAL AND EMOTIONAL WELLNESS. IN 2021, BHS WELLNESS OFFERED MANY SERVICES TO EMPLOYEES AND EXTERNAL COMPANIES USING A VIRTUAL ENVIRONMENT WHILE CONTINUING WORK WITH HEALTH LIVING WORKSHOPS, IMPROVING RESILIENCY, FINANCIAL WELLNESS, TOBACCO TREATMENT AND ACCESS TO MENTAL HEALTH WITH AN APPLICATION CALLED TALKSPACE. HEALTH AND CLINICAL INDICATORS: ADDITIONAL HEALTH INFORMATION THAT HELPS DEPICT THE PROFILE OF BERKSHIRE COUNTY INCLUDES: HEART DISEASE MORTALITY AGE ADJUSTED ANNUAL DEATH RATES PER 100,000 IN BERKSHIRE COUNTY (291.1) IS ABOVE THE STATE (254.4) AND BELOW THE NATIONAL AVERAGE (317.4). (CHNA) THE LEADING CAUSES OF CANCER DEATHS IN BERKSHIRE COUNTY ARE LUNG, BREAST, PROSTATE, COLORECTAL AND PANCREATIC. OVERALL, CANCER DEATH RATES IN BERKSHIRE COUNTY HAVE BEEN STEADY SINCE 2000. THE TOTAL CANCER AGE-ADJUSTED DEATH RATE IS HIGHER (152.9) THAN THE STATE AVERAGE IN 2015-2019 OF 146.9. (CHNA) OUTCOME MEASURES FOR SUBSTANCE ABUSE IN 2019 INCLUDE 1,978 ADMISSIONS TO DETOX, 858 ADMISSIONS TO CLINICAL STABILIZATION SERVICES (CSS), 716 ADMISSIONS TO JONES 2, AND 482 ADMISSIONS TO JONES 3. DIABETES IS ONE OF THE MULTIPLE CONDITIONS CONSIDERED TO BE RELATED TO CARDIOVASCULAR DISEASE. 2021 DATA FROM COUNTY HEALTH RANKINGS SHOWS THAT BERKSHIRE COUNTY HAS THE SECOND-HIGHEST PREVALENCE OF DIABETES IN THE STATE OF MASSACHUSETTS AT 10.7%. (BERKSHIRE COUNTY, MA / DATA USA) SMOKING IS AN ADDICTION THAT CAN CONTRIBUTE TO MULTIPLE MEDICAL CONDITIONS, FROM CARDIOVASCULAR DISEASE TO CANCER. DATA FROM THE 2021 COUNTY HEALTH RANKINGS SHOWS THAT BERKSHIRE COUNTY HAS THE SECOND-HIGHEST PREVALENCE OF SMOKING IN THE STATE OF MASSACHUSETTS AT 19%. (ADULT SMOKING IN MASSACHUSETTS & COUNTY HEALTH RANKINGS & ROADMAPS). WORKFORCE SHORTAGES AND ACCESS TO CARE: BERKSHIRE COUNTY RANKS 5TH OF 14 COUNTIES IN THE STATE FOR CLINICAL CARE AND ACCESS. THOUGH THE COUNTY PRESENTS WELL IN TERMS OF PROVIDER TO PATIENT RATIOS, PATIENTS FREQUENTLY STRUGGLE WITH APPOINTMENT AVAILABILITY AND TRANSPORTATION TO AND FROM HEALTHCARE LOCATIONS. BHS CONTINUES TO FACE STAFFING CHALLENGES, LIKE THOSE EXPERIENCED ACROSS THE NATION. TO ADDRESS THESE ISSUES, BHS HAS BEGUN TO CREATE CAREER TRAINING PROGRAMS, PARTICULARLY IN NURSING AREAS, THAT CAN SIMULTANEOUSLY HELP TO REDUCE CLINICIAN SHORTAGES AND IMPROVE EMPLOYMENT OPPORTUNITIES FOR BERKSHIRE RESIDENTS. (CHNA)

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:

1	Briefly describe the organization’s mission or most significant activities: TO ADVANCE HEALTH & WELLNESS OF OUR COMMUNITY IN A WELCOMING, INCLUSIVE, & PERSONALIZED ENVIRONMENT.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	22
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	19
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	3,716
6	Total number of volunteers (estimate if necessary) .............	6	89
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,226,667
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	1,225,667

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,993,447	2,934,577
9	Program service revenue (Part VIII, line 2g) .........	593,096,263	632,203,414
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	35,427,323	14,662,166
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,305,364	1,594,590
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	631,822,397	651,394,747
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	283,250,237	283,357,464
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 131,858
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	271,482,975	316,510,400
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	554,733,212	599,867,864
19	Revenue less expenses. Subtract line 18 from line 12.......	77,089,185	51,526,883
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	782,927,301	688,226,708
21	Total liabilities (Part X, line 26).............	242,071,297	189,375,195
22	Net assets or fund balances. Subtract line 21 from line 20.....	540,856,004	498,851,513

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 491,634,765 including grants of $ ) (Revenue $ 579,862,095 )
	OPERATE AN ACUTE CARE GENERAL HOSPITAL AND MEDICAL EDUCATIONAL FACILITY, AND TO DELIVER THE HIGHEST QUALITY PATIENT CENTERED CARE IN A LEARNING ENVIRONMENT. TOTAL PATIENT DAYS FOR THE YEAR ARE 61,340, TOTAL LAB PROCEDURES 1,690,942, TOTAL RADIOLOGY PROCEDURES 177,707, TOTAL REHAB VISITS 53,735. HOURS OF OPERATION 24/HRS 365/DAYS PER YEAR.

4b	(Code: ) (Expenses $ 34,785,832 including grants of $ ) (Revenue $ 41,389,349 )
	OPERATION OF AN EMERGENCY DEPARTMENT AND TRAUMA CARE CENTER AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. TOTAL VISITS FOR THE YEAR 59,588. ED IS IN OPERATION 24 HRS/DAY 365 DAYS/YEAR.

4c	(Code: ) (Expenses $ 14,301,096 including grants of $ ) (Revenue $ 8,300,726 )
	VISITING NURSE PROGRAM ALLOWING FOR THE CARE AND REHABILITATION OF PATIENTS IN THEIR OWN HOME ENVIRONMENT. TOTAL VISITS FOR THE YEAR 51,462 DETAILED AS FOLLOWS SKILLED NURSING 28,081 HOME HEALTH AIDE 2,141, REHAB 20,825, AND SOCIAL SERVICE 415. HOURS OF OPERATION 7 DAYS/WEEK 8AM-9PM WITH A NURSE ON CALL 24 HOURS.

	(Code: ) (Expenses $ 3,325,845 including grants of $ ) (Revenue $ 2,651,244 )
	OPERATE A SUBSTANCE ABUSE CENTER PROVIDING THE HIGHEST QUALITY OF PATIENT CARE. TOTAL PATIENT DAYS FOR THE YEAR 6,657. PROGRAM OPERATES 24 HRS/DAY 365 DAYS/YEAR.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 3,325,845 including grants of $ ) (Revenue $ 2,651,244 )
4e	Total program service expenses544,047,538

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,929,699	3,240,778	569,935

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	2,153,548

f	All other contributions, gifts, grants, and similar amounts not included above		1f	781,029

g	Noncash contributions included in lines 1a - 1f:$		1g	99,660

h Total. Add lines 1a-1f.......		2,934,577

		Business Code
2a	PATIENT SERVICES REVENUE	622000	522,904,714	522,904,714
b	OTHER ANCILLARY	622000	102,796,818	102,796,818
c	LAB REVENUE	621510	3,265,970	3,265,970
d	HEALTH PROMO EDUCATION	611710	1,785,024	1,785,024
e	PSYCH PROF SERVICES	621112	1,450,888	1,450,888
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		632,203,414

3 Investment income (including dividends, interest, and othersimilar amounts) ......			5,556,782		1,226,667	4,330,115
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		634,836	6a
b	Less: rental expenses		564,137	6b
c	Rental income or (loss)		70,699	6c
d	Net rental income or (loss).......			70,699			70,699
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	4,582	10,795,825	7a
b	Less: cost or other basis and sales expenses	0	1,695,023	7b
c	Gain or (loss)	4,582	9,100,802	7c
d	Net gain or (loss).........			9,105,384			9,105,384
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA INCOME		722514	1,523,891			1,523,891
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,523,891
12	Total revenue. See instructions.....			651,394,747	632,203,414	1,226,667	15,030,089

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
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 ...........	1,184,640		1,184,640
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	218,755,000	216,363,837	2,338,633	52,530
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	8,469,835	8,254,212	215,623
9	Other employee benefits .......	35,863,219	35,289,408	573,811
10	Payroll taxes ...........	19,084,770	18,779,414	305,356
11	Fees for services (non-employees):
a	Management ......	45,760,031		45,760,031
b	Legal .........
c	Accounting ...........
d	Lobbying ...........	43,265	43,265
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	93,348		93,348
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	30,625,711	29,994,431	631,280
12	Advertising and promotion ....
13	Office expenses .......	301,743	296,423	4,820	500
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	6,982,843	6,871,117	111,726
17	Travel ............	525,256	516,852	8,404
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	485,281	477,516	7,765
21	Payments to affiliates .......	521,100	521,100
22	Depreciation, depletion, and amortization ..	34,745,879	34,192,153	553,726
23	Insurance ...	5,262,673	5,178,470	84,203
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	PATIENT RELATED SUPPLY	164,954,035	162,215,443	2,670,344	68,248
b	EQUIPMENT RENTAL/PURCHA	11,546,696	11,082,227	464,469
c	BAD DEBT	9,635,237	9,635,237
d
e	All other expenses	5,027,302	4,336,433	680,289	10,580
25	Total functional expenses. Add lines 1 through 24e	599,867,864	544,047,538	55,688,468	131,858
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			13,545	1	14,596
2	Savings and temporary cash investments .........			157,777,644	2	103,657,235
3	Pledges and grants receivable, net ......			193,004	3	297,880
4	Accounts receivable, net .............			52,355,377	4	51,325,537
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 ...........			15,834,951	7	17,597,427
8	Inventories for sale or use ............			13,852,607	8	15,289,308
9	Prepaid expenses and deferred charges ......			2,417,168	9	3,046,981
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	704,695,700
b	Less: accumulated depreciation	10b	524,139,003	193,273,759	10c	180,556,697
11	Investments—publicly traded securities .			276,388,683	11	254,588,901
12	Investments—other securities. See Part IV, line 11 .....			41,740,004	12	35,268,918
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			29,080,559	15	26,583,228
16	Total assets. Add lines 1 through 15 (must equal line 33)...			782,927,301	16	688,226,708

17	Accounts payable and accrued expenses .....	62,352,196	17	67,565,877
18	Grants payable ...		18
19	Deferred revenue .........	219,435	19	396,924
20	Tax-exempt bond liabilities .........	55,026,720	20	49,561,200
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 ..		23	3,817,520
24	Unsecured notes and loans payable to unrelated third parties ..		24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	124,472,946	25	68,033,674
26	Total liabilities. Add lines 17 through 25..	242,071,297	26	189,375,195

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	501,052,147	27	462,881,749
28	Net assets with donor restrictions ...........	39,803,857	28	35,969,764
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	540,856,004	32	498,851,513
33	Total liabilities and net assets/fund balances ........	782,927,301	33	688,226,708

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)BERKSHIRE HEALTH SYSTEMS INC 725 NORTH ST PITTSFIELD,MA01201 04-2442944	PARENT CORP	MA	501 (C)(3)	12B-II	N/A		No
(2)FAIRVIEW HOSPITAL 725 NORTH ST PITTSFIELD,MA01201 04-2133860	ACUTE CARE	MA	501 (C)(3)	3	N/A		No
(3)BERKSHIRE FACULTY SERVICES INC 725 NORTH ST PITTSFIELD,MA01201 04-2995053	PHYSICIAN SVC	MA	501 (C)(3)	12B-II	N/A		No
(4)BHS MANAGEMENT SERVICES INC 725 NORTH ST PITTSFIELD,MA01201 22-2755258	MANAGEMENT	MA	501 (C)(3)	12B-II	N/A		No

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

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership