TY 2023 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	25.00 ................. 25.00	X	X	0	1,055,499	37,153
(2) RICHARD ALCOMBRIGHT...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(3) ALFRED A BARBALUNGA...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(4) ALEC A BELMAN MD...................................................................... TRUSTEE/PHYSICIAN	1.00 ................. 50.00	X		0	411,303	69,757
(5) JASON BRATCHER MD...................................................................... TRUSTEE/PHYSICIAN TERM BEGAN 1/24	1.00 ................. 50.00	X		0	641,839	30,341
(6) ALBERT A BRAVO DPM...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(7) TIMOTHY BURKE...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(8) ROBERT P CELLA JR MD...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(9) SHAWN V CUSSON...................................................................... TRUSTEE/TERM BEGAN 1/24	1.00 ................. 2.00	X		0	0	0
(10) EDITH KIT DOBELLE...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(11) DAVID HALL...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(12) LETICIA SE HAYNES...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(13) EDMUND HORNSTEIN DO...................................................................... TRUSTEE/PHYSICIAN	1.00 ................. 50.00	X		103,793	227,182	380
(14) SUSAN KORMANIK...................................................................... TRUSTEE	1.00 ................. 2.00	X		0	0	0
(15) JOHN A LOIODICE MD...................................................................... TRUSTEE/PHYSICIAN	1.00 ................. 50.00	X		0	250,636	38,038
(16) KATHLEEN M MCCORMICK ESQ...................................................................... TRUSTEE	1.00 ................. 2.00	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) LAURIE NORTON MOFFATT........................................................................ TRUSTEE	1.00 .......................2.00	X				0	0	0
(19) FREDERICK PUDDESTER........................................................................ TRUSTEE	1.00 .......................2.00	X				0	0	0
(20) BARTON D RASOR........................................................................ TRUSTEE/CHAIRMAN	1.00 .......................2.00	X	X			0	0	0
(21) DEBORAH RENZI........................................................................ TRUSTEE/TERM BEGAN 1/24	1.00 .......................2.00	X				0	0	0
(22) JEANETTE SMITH PHD........................................................................ TRUSTEE/TERM BEGAN 1/24	1.00 .......................2.00	X				0	0	0
(23) ANAKATINA CORDON SUFFISH........................................................................ TRUSTEE	1.00 .......................2.00	X				0	0	0
(24) JOHN L BISSELL........................................................................ TRUSTEE/TERM END 12/23	1.00 .......................2.00	X	X			0	0	0
(25) BRONLY S BOYD........................................................................ TRUSTEE/TERM END 12/23	1.00 .......................2.00	X				0	0	0
(26) CAROL G SIEGEL........................................................................ TRUSTEE/TERM END 12/23	1.00 .......................2.00	X				0	0	0
(27) ERWIN A STUEBNER JR MD........................................................................ TRUSTEE/TERM END 12/23	1.00 .......................2.00	X				0	0	0
(28) SCOTT ST GEORGE........................................................................ TREASURER	37.00 .......................13.00		X			0	602,502	25,392
(29) CHERYL M BOUDREAU........................................................................ CLERK	19.00 .......................21.00		X			0	129,314	19,721
(30) MICHAEL MCHUGH MD........................................................................ CHAIRMAN-E.D. MEDICINE	50.00 .......................0.00			X		480,975	0	43,523
(31) ANDREW MANZER........................................................................ CHIEF OPERATING OFFICER	50.00 .......................0.00			X		520,187	0	54,298
(32) BRENDA E CADORETTE........................................................................ CHIEF NURSING OFFICER	50.00 .......................0.00			X		350,064	0	45,325
(33) ROBIN BURNS-LAMBERT MD........................................................................ ANESTHESIOLOGIST	50.00 .......................0.00				X	988,385	0	55,654
(34) SEETHA MUTHAVARAPU MD........................................................................ HOSPITALIST	50.00 .......................0.00				X	712,241	0	56,371
(35) RAYMOND GARY SOHL MD........................................................................ ANESTHESIOLOGIST	50.00 .......................0.00				X	627,424	0	41,039
(36) DAVID POMERANTZ MD........................................................................ ANESTHESIOLOGIST	50.00 .......................0.00				X	530,843	0	66,059
(37) LJILJANA MARKOVIC MD........................................................................ CHAIR OF PSYCHIATRY	50.00 .......................0.00				X	521,071	0	40,937

(A) Name and business address	(B) Description of services	(C) Compensation
AHSA PO BOX 738891 DALLAS,TX753738891	CONTRACTED LABOR	24,374,628
SHIELDS PHARMACY OF THE BERKSHIRE PO BOX 844023 BOSTON,MA022844023	PHARMACY CONSULTANT	7,764,828
MEDTIGO STAFFING LLC PO BOX 397 DOVER,MA02030	CONTRACTED LABOR	3,219,006
FASTAFF LLC 5700 S QUEBEC ST SUITE 300 GREENWOOD VILLAGE,CO08111	CONTRACTED LABOR	3,096,314
AYA HEALTHCARE INC 5930 CORNERSTONE CT WEST SUITE 300 SAN DIEGO,CA09212	CONTRACTED LABOR	2,871,833
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 36

- 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

2023

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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

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) 2023

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) 2023

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) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

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

2023

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) (2023)

Schedule B (Form 990) (2023) 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) (2023)

Schedule B (Form 990) (2023)

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) (2023)

Schedule B (Form 990) (2023)

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) (2023)

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

right arrow

Complete if the organization is described below. 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

2022

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 .................................................................... right arrow

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

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

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

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) 2022

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 right arrow

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 right arrow

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) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

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

54,462

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

54,462

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 ADVOCATE FOR APPROPRIATE FUNDING FOR FYE 9/30/2024. CALCULATION OF THE LOBBYING FEE PORTION OF THE ANNUAL DUES ARE AS FOLLOWS: MHA LOBBYING FEES OF $30,423 ARE 15.4% OF THE $197,549 ANNUAL DUES. AHA LOBBYING FEES OF $24,039 ARE 39.00% OF THE $61,639 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 ADVOCATE FOR APPROPRIATE FUNDING FOR FYE 9/30/2024. CALCULATION OF THE LOBBYING FEE PORTION OF THE ANNUAL DUES ARE AS FOLLOWS: MHA LOBBYING FEES OF $30,423 ARE 15.4% OF THE $197,549 ANNUAL DUES. AHA LOBBYING FEES OF $24,039 ARE 39.00% OF THE $61,639 ANNUAL DUES.

Schedule C (Form 990) 2022

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.
right arrow

Attach to Form 990.
right arrow

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

OMB No. 1545-0047

2022

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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

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

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

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 ....	34,493,283	31,583,433	35,358,308	30,131,752	28,399,191
b	Contributions ...
c	Net investment earnings, gains, and losses	6,879,269	2,925,103	-3,740,481	5,235,776	1,747,061
d	Grants or scholarships ...	-12,000	-14,500	-14,000	-8,500	-5,500
e	Other expenditures for facilities and programs ...		-753	-20,393	-720	-9,000
f	Administrative expenses ....
g	End of year balance ......	41,360,552	34,493,283	31,583,433	35,358,308	30,131,752

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

19.060 %

Term endowment right arrow

80.940 %

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 .....	9,337,605		9,337,605
b	Buildings ....	234,448,905	158,543,645	75,905,260
c	Leasehold improvements
d	Equipment ....	215,278,333	155,403,114	59,875,219
e	Other .....	41,592,927	20,596,033	20,996,894
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				166,114,978

Schedule D (Form 990) 2022

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	67,559,592	C
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	67,559,592

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
DUE TO THIRD PARTIES	47,753,841
DEFERRED COMPENSATION	11,523,591
WORKERS COMP STOP LOSS LIABILITY	332,000
ASSET RETIREMENT ACCRETION	5,337,771
LEASE LIABILITY	310,290




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	65,257,493
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) 2022

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, 2024 AND 2023. 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) 2022

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 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2023

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) . . .	1,174,326	47,467	1,126,859	0.180 %
b	Medicaid (from Worksheet 3, column a) . . . . .	82,584,078	70,123,830	12,460,248	1.960 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	7,892,847	12,283,511
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	91,651,251	82,454,808	13,587,107	2.140 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	7,158,370	2,848,105	4,310,265	0.680 %
f	Health professions education (from Worksheet 5) . . .	13,496,303	5,774,541	7,721,762	1.210 %
g	Subsidized health services (from Worksheet 6) . . . .	17,243,853	12,083,530	5,160,323	0.810 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	403,794	0	403,794	0.060 %
j	Total. Other Benefits . .	38,302,320	20,706,176	17,596,144	2.760 %
k	Total. Add lines 7d and 7j .	129,953,571	103,160,984	31,183,251	4.900 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements			1,942	0	1,942	0 %
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development			758,386	25,479	732,907	0.120 %
9	Other
10	Total			760,328	25,479	734,849	0.120 %

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. ......

22,573,350

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).....

192,693,534

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

269,173,266

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

-76,479,732

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) 2023

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) 2023

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 22

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 22

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) 2023

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) 2023

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) 2023

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) 2023

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: IN 2022, BHS JOINED THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS/INSURER ("THE COALITION"), A PARTNERSHIP FORMED IN 2012 TO COORDINATE RESOURCES AND ACTIVITIES, AND IT CURRENTLY CONSISTS OF TEN NONPROFIT HOSPITALS, CLINICS, AND INSURERS IN THE REGION. THE COALITION MEMBERS COORDINATE TO CONDUCT THEIR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA). ALTHOUGH BHS CONDUCTED A CHNA IN 2021, IT COMMISSIONED THIS 2022 CHNA SO THAT IT CAN COLLABORATE AROUND SHARED PRIORITIES GOING FORWARD. THE COALITION WORKED WITH A CONSULTANT TEAM LED BY THE PUBLIC HEALTH INSTITUTE OF WESTERN MASSACHUSETTS (PHIWM) TO CONDUCT THE CHNA. THIS ASSESSMENT FOCUSED ON THE BERKSHIRE HEALTH SYSTEMS SERVICE AREA OF BERKSHIRE COUNTY AS WELL AS DATA FOR SELECT COMMUNITIES AS AVAILABLE: GREAT BARRINGTON, NORTH ADAMS, AND PITTSFIELD.THE 2022 BHS CHNA UPDATES THE PRIORITIZED COMMUNITY HEALTH NEEDS IDENTIFIED IN PREVIOUS REPORTS, AS THEY RELATE TO: THE SOCIAL AND ECONOMIC FACTORS OR DETERMINANTS THAT INFLUENCE HEALTH, BARRIERS TO HEALTHCARE ACCESS, AND HEALTH BEHAVIORS AND OUTCOMES. ITS PRODUCTION WAS GUIDED AND INFORMED BY THE COALITION'S 2022 CHNA STRUCTURE AND PROCESS, WHICH CONSISTED OF: A REVIEW OF EXISTING ASSESSMENT REPORTS; SURVEY OF PUBLIC HEALTH OFFICIALS; PRELIMINARY ANALYSIS OF COVID-19'S IMPACT ON THE REGION; AND ANALYSIS OF QUANTITATIVE DATA, WITH EFFORTS WHERE POSSIBLE TO DISAGGREGATE (E.G., BY RACE, ETHNICITY, GENDER, AGE, LGBTQIA+, GEOGRAPHY) TO UNDERSTAND HEALTH DISPARITIES. AS PART OF THE CHNA PROCESS, BERKSHIRE HEALTH SYSTEMS MADE THE DECISION TO (1) ASSESS THE IMPACT OF COVID-19 ON HEALTH NEEDS IN THE COUNTY; AND (2) CHOSE TWO OF THE IDENTIFIED PRIORITIZED NEEDS FROM 2021 FOR A DEEPER DIVE AND ADDITIONAL DATA GATHERING: CHRONIC CONDITIONS AND MENTAL HEALTH/SUBSTANCE USE DISORDER. BERKSHIRE HEALTH SYSTEMS CHOSE TO PLACE GREATEST FOCUS ON INEQUITIES AMONG ADOLESCENTS AND TEENAGERS, OLDER ADULTS, AND MEDICALLY UNDERSERVED INDIVIDUALS.THE FOLLOWING IS A SUMMARY OF THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2022 CNHA, ORGANIZED INTO THREE OVERARCHING CATEGORIES:YOUTH MENTAL HEALTH (REGIONAL FOCUS AREA)SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTH A. SOCIAL ENVIRONMENTB. HOUSING NEEDSC. ACCESS TO HEALTHY FOOD, TRANSPORTATION, AND PLACES TO BE ACTIVE.D. EMPLOYMENT AND INCOMEE. EDUCATIONAL NEEDSBARRIERS TO ACCESSING QUALITY HEALTH CAREA. INSURANCE AND HEALTH CARE RELATED CHALLENGES B. LIMITED AVAILABILITY OF PROVIDERS C. NEED FOR INCREASED CULTURALLY SENSITIVE CARE D. NEED FOR TRANSPORTATIONE. LACK OF CARE COORDINATION F. HEALTH LITERACY AND LANGUAGE BARRIERS HEALTH CONDITIONS AND BEHAVIORSA. MENTAL HEALTH AND SUBSTANCE USE (BERKSHIRE HEALTH SYSTEMS FOCUS AREA)B. CHRONIC HEALTH CONDITIONS (BERKSHIRE HEALTH SYSTEMS FOCUS AREA)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 2022-2024. 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 ADVISORY COMMITTEE:THE GOVERNING BODY OF BERKSHIRE MEDICAL CENTER (BMC) IS COMPOSED OF COMMUNITY VOLUNTEERS, PHYSICIAN REPRESENTATIVES FROM THE HOSPITAL'S MEDICAL STAFF, AND THE CHIEF EXECUTIVE OFFICER. COMMUNITY VOLUNTEERS ARE ELECTED TO SERVE TERMS OF UP TO THREE YEARS, ARE SUBJECT TO TERM LIMITS, AND REPRESENT A DIVERSE RANGE OF COMMUNITY INTERESTS-INCLUDING SOCIAL SERVICE PROVIDERS, LOCAL BUSINESS LEADERS, FINANCIAL PROFESSIONALS, CONSUMER ADVOCATES, AND EDUCATIONAL LEADERS. BHS HAS ESTABLISHED THE HEALTH EQUITY AND ACCESS COMMITTEE OF THE BOARD OF TRUSTEES. THIS COMMITTEE IS MADE UP OF BOARD MEMBERS AND COMMUNITY MEMBERS WITH A FOCUS ON MOVING FORWARD THE HEALTH EQUITY STRATEGY, AS WELL AS THE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IS DEVELOPED BY BHS HOSPITALS, IN PARTNERSHIP WITH MEMBERS OF THE COMMUNITY ON THE COMMUNITY BENEFIT ADVISORY COMMITTEE, WHICH REVIEWS AND DISCUSSES COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, AND COMMUNITY NEEDS AND OUTCOMES. OUR CBAC INCURRED CHANGES IN ITS LEADERSHIP STRUCTURE AND IS CURRENTLY BEING REESTABLISHED.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 2022-2024 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 2022-2024 TIMEFRAME. LISTED BELOW ARE THE HOSPITAL'S FY24 STRATEGIC PRIORITY HEALTH NEEDS, AND HOW EACH IS ADDRESSED. THE FY24 PRIORITY HEALTH NEEDS ARE UPDATED FROM THE TRIANNUAL FY22 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. BMC ALSO DEPLOYS VENDING MACHINES THROUGHOUT THE COUNTY TO PROVIDE FREE HARM REDUCTION SUPPLIES. ADDITIONALLY, BMC HAS INSTALLED NUMEROUS NARCAN BOXES ACROSS THE COUNTY WHERE ANYONE CAN ACCESS THE LIFE-SAVING MEDICATION. 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 2022 CHNA REPORT IS AVAILABLE ON THE HOSPITAL WEBSITE, HTTPS://WWW.BERKSHIREHEALTHSYSTEMS.ORG/COMMUNITYWELLNESS/UNDER COMMUNITY HEALTH CLICK ON THE LINK FOR BERKSHIRE HEALTH SYSTEMS COMMUNITY HEALTH NEED ASSESSMENT
PART V SECTION B LINE 10A	THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE ON THE HOSPITAL WEBSITE,HTTPS://WWW.BERKSHIREHEALTHSYSTEMS.ORG/COMMUNITYWELLNESS/UNDER COMMUNITY HEALTH CLICK ON THE LINK FOR BERKSHIRE MEDICAL CENTER-COMMUNITY HEALTH NEEDS IMPLEMENTATION PLAN (2022-2024)
PART V SECTION B LINE 16A	THE HOSPITAL'S FAP IS AVAILABLE ON THE HOSPITAL WEBSITE, HTTPS://WWW.BERKSHIREHEALTHSYSTEMS.ORG/PATIENT-JOURNEY/BILLING-AND-FINANCES/SELECT FINANCIAL ASSISTANCE INFORMATION 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, HTTPS://WWW.BERKSHIREHEALTHSYSTEMS.ORG/PATIENT-JOURNEY/BILLING-AND-FINANCES/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, HTTPS://WWW.BERKSHIREHEALTHSYSTEMS.ORG/PATIENT-JOURNEY/BILLING-AND-FINANCES/,THEN SELECT THE DOCUMENT "PLAIN LANGUAGE SUMMARY OF FINANCIAL ASSISTANCE POLICIES".

Schedule H (Form 990) 2023

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) 2023

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 $22,573,350 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.
PART II, COMMUNITY BUILDING ACTIVITIES:	ENVIRONMENTAL IMPROVEMENTS $1,942WORKFORCE DEVELOPMENT $732,906: 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, 2024 AND 2023 ARE LISTED ON PAGE 12 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:THE COMMUNITY BENEFITS MISSION STATEMENT OF BERKSHIRE MEDICAL CENTER AND BERKSHIRE HEALTH SYSTEMS (BHS) IS TO ADVANCE HEALTH AND WELLNESS FOR EVERYONE IN OUR COMMUNITY IN A WELCOMING, INCLUSIVE, AND PERSONALIZED ENVIRONMENT. AT BERKSHIRE HEALTH SYSTEMS, WE KNOW THAT OVERALL WELLNESS IS THE RESULT OF HEALTHY FAMILIES, HEALTHY ENVIRONMENTS, AND HEALTHY COMMUNITIES, NOT JUST EXCELLENT MEDICAL CARE. THERE, WE SUPPORT OUR PATIENTS BEYOND THE HOSPITAL, CLINIC, OR MEDICAL OFFICE. WE RECOGNIZE THAT EACH OF OUR PATIENTS HAS UNIQUE NEEDS AND CHALLENGES. WE STRIVE TO MAKE EACH EXPERIENCE WITH BHS ONE THAT IS WELCOMING PERSONALIZED, AND CONVENIENT FOR THE PATIENT. WE MAKE CONNECTIONS AND PROMOTE COMMUNITY SERVICES THAT GIVE PATIENTS THE TOOLS TO LIVE HEALTHIER LIVES. ACROSS BHS'S COMMUNITY TEACHING HOSPITAL, BERKSHIRE MEDICAL CENTER, AND TWO CRITICAL ACCESS HOSPITALS, FAIRVIEW HOSPITAL AND NORTH ADAMS REGIONAL HOSPITAL, WE WORK TOGETHER TO SUPPORT PATIENT NEEDS. TOGETHER, OUR CRITICAL ACCESS HOSPITALS HELP US BETTER SERVE THE NEEDS OF OUR COMMUNITIES - KEEPING PATIENTS LOCAL WHENEVER POSSIBLE AND SEAMLESSLY TRANSPORTING THEM TO BMC IF A MORE ADVANCED LEVEL OF CARE IS NEEDED. COMMUNITY BENEFIT ADVISORY COMMITTEE (CBAC):THE GOVERNING BODY OF BERKSHIRE MEDICAL CENTER (BMC) IS COMPOSED OF COMMUNITY VOLUNTEERS, PHYSICIAN REPRESENTATIVES FROM THE HOSPITAL'S MEDICAL STAFF, AND THE CHIEF EXECUTIVE OFFICER. COMMUNITY VOLUNTEERS ARE ELECTED TO SERVE TERMS OF UP TO THREE YEARS, ARE SUBJECT TO TERM LIMITS, AND REPRESENT A DIVERSE RANGE OF COMMUNITY INTERESTS-INCLUDING SOCIAL SERVICE PROVIDERS, LOCAL BUSINESS LEADERS, FINANCIAL PROFESSIONALS, CONSUMER ADVOCATES, AND EDUCATIONAL LEADERS. BHS HAS ESTABLISHED THE HEALTH EQUITY AND ACCESS COMMITTEE OF THE BOARD OF TRUSTEES. THIS COMMITTEE IS MADE UP OF BOARD MEMBERS AND COMMUNITY MEMBERS WITH A FOCUS ON MOVING FORWARD THE HEALTH EQUITY STRATEGY, AS WELL AS THE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IS DEVELOPED BY BHS HOSPITALS, IN PARTNERSHIP WITH MEMBERS OF THE COMMUNITY ON THE COMMUNITY BENEFIT ADVISORY COMMITTEE, WHICH REVIEWS AND DISCUSSES COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, AND COMMUNITY NEEDS AND OUTCOMES. OUR CBAC INCURRED CHANGES IN ITS LEADERSHIP STRUCTURE AND IS CURRENTLY BEING REESTABLISHED. 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. IN 2022, BHS JOINED THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS/INSURER ("THE COALITION"), A PARTNERSHIP FORMED IN 2012 TO COORDINATE RESOURCES AND ACTIVITIES, AND IT CURRENTLY CONSISTS OF TEN NONPROFIT HOSPITALS, CLINICS, AND INSURERS IN THE REGION. THE COALITION MEMBERS COORDINATE TO CONDUCT THEIR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA). THE COALITION WORKED WITH A CONSULTANT TEAM LED BY THE PUBLIC HEALTH INSTITUTE OF WESTERN MASSACHUSETTS (PHIWM) TO CONDUCT THE CHNA. ITS PRODUCTION WAS GUIDED AND INFORMED BY THE COALITION'S 2022 CHNA STRUCTURE AND PROCESS, WHICH CONSISTED OF: A REVIEW OF EXISTING ASSESSMENT REPORTS; SURVEY OF PUBLIC HEALTH OFFICIALS; PRELIMINARY ANALYSIS OF COVID-19'S IMPACT ON THE REGION; AND ANALYSIS OF QUANTITATIVE DATA, WITH EFFORTS WHERE POSSIBLE TO DISAGGREGATE (E.G., BY RACE, ETHNICITY, GENDER, AGE, LGBTQIA+, GEOGRAPHY) TO UNDERSTAND HEALTH DISPARITIES. THE NEEDS DATA, ALONG WITH STATE-ESTABLISHED PRIORITIES, ARE USED TO DETERMINE OUR ANNUAL COMMUNITY BENEFIT AREAS OF FOCUS. IN ITS PLANNING, BHS CONTINUALLY LOOKS FOR OPPORTUNITIES TO MORE IMPACTFUL USE OF EXISTING RESOURCES, SEEKS PHILANTHROPIC OPPORTUNITIES, AS WELL AS WAYS TO IDENTIFY GAPS IN SERVICE AND BUILD PROGRAMS OR PARTNERSHIPS TO SUPPORT COMMUNITY NEEDS.DATA SOURCESCOMMUNITY FOCUS GROUPS, HOSPITAL DATA, CONSUMER AND ADVISORY GROUPS, INTERVIEWS, PUBLIC HEALTH PERSONNEL, SURVEYS, FEDERAL, STATE, AND MUNICIPAL DATA SOURCES, INDUSTRY GROUPS AND NONPROFIT REPORTSGOALS: STATEWIDE PRIORITIES AS PART OF OUR PLANNING PROCESS, BHS INCORPORATES THE MASSACHUSETTS STATEWIDE PRIORITIES AND THE MA DEPARTMENT OF PUBLIC HEALTH PRIORITIES TO GUIDE OUR COMMUNITY BENEFIT INVESTMENTS. 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 DEVELOPMENTACCESS TO AFFORDABLE HOUSING COMMUNITY PARTNERS:BERKSHIRE AHEC, BERKSHIRE COUNTY BOARD OF HEALTH ASSOCIATION, BERKSHIRE BOUNTY, BERKSHIRE BREAST HEALTH TEAM, BERKSHIRE COMMUNITY ACTION COUNCIL, 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 FALLON HEALTH COLLABORATIVE, BERKSHIRE IMMIGRANT CENTER, 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, 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 EVALUATION:THE 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, MASSACHUSETTS IS THE MOST WESTERN OF THE 14 COUNTIES IN MASSACHUSETTS. WITH ABOUT 12% OF THE LANDMASS 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. DATA FROM THE US CENSUS BUREAU FOR 2024 ESTIMATES THE POPULATION OF BERKSHIRE COUNTY TO BE 128,726. US CENSUS BUREAU ACS 2016-2020 INFORMED THE DATA USED IN THE FOLLOWING SUMMARY OF THE BERKSHIRE COMMUNITY:THE SERVICE AREA CONSISTS OF RESIDENTS WHO IDENTIFY AS PREDOMINANTLY WHITE NON-HISPANIC RACE AND ETHNICITY, THOUGH THIS VARIES IN SOME COMMUNITIES. BERKSHIRE COUNTY HAS A LARGER PROPORTION OF BLACK AND LATINO/A/E RESIDENTS COMPARED TO THE PREVIOUS CHNA. BERKSHIRE COUNTY PRIMARILY HAS WHITE RESIDENTS (90%). SOME OF THE SERVICE AREA'S POPULATION IS FROM OTHER COUNTRIES. FOR EXAMPLE, IN BERKSHIRE COUNTY, 12% OF RESIDENTS ARE FOREIGN-BORN. IN GREAT BARRINGTON, NORTH ADAMS, AND PITTSFIELD, 6% OF RESIDENTS ARE FOREIGN-BORN. ABOUT ONE IN TEN PEOPLE IN GREAT BARRINGTON (10%), NORTH ADAMS (9%), AND PITTSFIELD (9%) SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME.ECONOMICALLY, BERKSHIRE COUNTY HAS A STRONG TOURISM INDUSTRY THAT REVOLVES AROUND ITS NATURAL BEAUTY AND CREATIVE COMMUNITIES. THE MEDIAN HOUSEHOLD INCOME IN BERKSHIRE COUNTY IS 30% LOWER THAN THAT OF THE STATE. ONLY 19% OF THE POPULATION AGED 25 AND OVER IN BERKSHIRE COUNTY HAS A BACHELOR'S DEGREE, COMPARED TO 45% STATEWIDE. UNEMPLOYMENT IN BERKSHIRE COUNTY IS SIMILAR TO THE STATEWIDE LEVEL OF 5%. THE MEDIAN AGE FOR THE SERVICE AREA IS SEVEN YEARS OLDER THAN THAT OF THE STATE. THE OLDER ADULT POPULATION IS EXPECTED TO GROW IN THE NEAR FUTURE, WHICH MAY AFFECT THE SERVICES NEEDED IN THE COUNTY. APPROXIMATELY 16% OF RESIDENTS IN THE BERKSHIRE HEALTH SYSTEMS SERVICE AREA HAVE DISABILITIES. SELECTED COMMUNITIES IN THE SERVICE AREA HAVE SIMILAR RATES OF DISABILITY (GREAT BARRINGTON 11%, NORTH ADAMS 18%, AND PITTSFIELD 18%). IN BERKSHIRE COUNTY, 9% OF LATINO/A/E RESIDENTS HAVE DISABILITIES COMPARED TO 16% OF ALL RESIDENTS IN THE COUNTY. PEOPLE WITH DISABILITIES TEND TO HAVE HIGHER RATES OF POVERTY. FOR EXAMPLE, IN BERKSHIRE COUNTY AND THE SELECTED COMMUNITIES, THE POVERTY RATE AMONG THOSE WITH A DISABILITY WAS 2-4 TIMES HIGHER THAN FOR PEOPLE WITHOUT A DISABILITY. 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.
PART VI, LINE 5:	THE GOVERNING BODY OF BERKSHIRE MEDICAL CENTER (BMC) IS COMPOSED OF COMMUNITY VOLUNTEERS, PHYSICIAN REPRESENTATIVES FROM THE HOSPITAL'S MEDICAL STAFF, AND THE CHIEF EXECUTIVE OFFICER. COMMUNITY VOLUNTEERS ARE ELECTED TO SERVE TERMS OF UP TO THREE YEARS, ARE SUBJECT TO TERM LIMITS, AND REPRESENT A DIVERSE RANGE OF COMMUNITY INTERESTS-INCLUDING SOCIAL SERVICE PROVIDERS, LOCAL BUSINESS LEADERS, FINANCIAL PROFESSIONALS, CONSUMER ADVOCATES, AND EDUCATIONAL LEADERS. MOST COMMITTEES OF THE BOARD OF TRUSTEES ALSO INCLUDE ADDITIONAL COMMUNITY REPRESENTATIVES. BERKSHIRE HEALTH SYSTEMS (BHS) MAINTAINS A PATIENT AND FAMILY ADVISORY COUNCIL (PFAC) TO PROVIDE INPUT AND ADVICE ON A WIDE VARIETY OF SERVICE-RELATED TOPICS.THE MEDICAL STAFF OF BHS IS OPEN TO ALL PHYSICIANS WHO MEET ESTABLISHED CLINICAL AND PATIENT SERVICE CRITERIA. HOWEVER, CERTAIN HOSPITAL-BASED SERVICES-SUCH AS RADIOLOGY, ANESTHESIA, EMERGENCY DEPARTMENT, AND PATHOLOGY-ARE FUNCTIONALLY CLOSED DUE TO THE ORGANIZATIONAL STRUCTURE OF THOSE DEPARTMENTS.BMC REGULARLY INVESTS BOTH PERSONNEL AND FINANCIAL RESOURCES TO SUPPORT COMMUNITY INITIATIVES THAT PROMOTE HEALTH AND WELL-BEING, WITHOUT EXPECTATION OF REIMBURSEMENT. THE HOSPITAL ALLOCATES SURPLUS FUNDS FOR CAPITAL IMPROVEMENTS, MAINTAINS ACCESS TO PATIENT SERVICES, AND EXPANDS CARE ACCESS POINTS TO ADVANCE COMMUNITY BENEFIT PRIORITIES FOR PATIENTS THROUGHOUT THE REGION.BERKSHIRE COUNTY HAS LONG FACED A CRITICAL SHORTAGE OF PHYSICIANS IN VARIOUS SPECIALTIES. IN RESPONSE, BHS HAS DEDICATED SIGNIFICANT PERSONNEL TIME AND FINANCIAL RESOURCES TO RECRUIT PHYSICIANS AS DIRECT EMPLOYEES OF BHS OR ITS AFFILIATES. ADDITIONALLY, BMC HAS PROVIDED SUBSTANTIAL ASSISTANCE TO COMMUNITY MEDICAL PRACTICES, SUPPORTING THE RECRUITMENT AND SUCCESSFUL START-UP OF NEW PHYSICIANS IN HIGH-NEED SPECIALTIES.BHS IS ALSO FOCUSED ON FILING NON-PHYSICIAN ROLES THROUGH CAREER PATHWAY PROGRAMS, OFFERING PAID TRAINING OPPORTUNITIES WHERE PROFESSIONALS ARE ABLE TO LEARN VALUABLE SKILLS, EARN CERTIFICATIONS, AND FAST-TRACK PROGRESS TOWARD A CAREER IN HEALTHCARE. CAREER PATHWAY PROGRAMS ARE PAID EDUCATIONAL OPPORTUNITIES SPECIFICALLY DESIGNED TO FOSTER A TALENTED, DIVERSE WORKFORCE BY BREAKING DOWN BARRIERS THAT HAVE TRADITIONALLY PREVENTED MANY INDIVIDUALS INTERESTED IN HEALTHCARE FROM JOINING OUR WORKFORCE. BMC IS SPECIFICALLY FOCUSED ON BUILDING PATHWAYS TO THE MOST IMMEDIATELY NEEDED ROLES: NURSING ASSISTANTS, MEDICAL ASSISTANTS, LICENSED PRACTICAL NURSES, AND REGISTERED NURSES. THIS IS ACHIEVED THROUGH PAID IN-HOUSE TRAINING PROGRAMS AND PARTNERSHIPS WITH LOCAL EDUCATIONAL INSTITUTIONS LIKE BERKSHIRE COMMUNITY COLLEGE AND MCCANN TECHNICAL SCHOOL. IN 2023, THE SYSTEM ANNOUNCED A NEW PARTNERSHIP WITH MASSACHUSETTS COLLEGE OF LIBERAL ARTS, HELPING LAUNCH A 4-YEAR BACHELOR OF SCIENCE IN NURSING PROGRAM, DESIGNED TO HELP GROW THE NEXT GENERATION OF NURSES AND HEALTHCARE PROFESSIONALS IN THE BERKSHIRES.THE HEALTH SYSTEM IS ALSO ADDRESSING CRITICAL SHORTAGES IN NURSING AND OTHER HEALTHCARE PROFESSIONS. AS DETAILED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), BMC CONSISTENTLY GOES ABOVE AND BEYOND TO SUPPORT COMMUNITY HEALTH THROUGH EXTENSIVE OUTREACH PROGRAMS AND COMPREHENSIVE, COMMUNITY-BASED INITIATIVES. THESE EFFORTS ADDRESS A WIDE RANGE OF HEALTHCARE CHALLENGES, INCLUDING DIABETES, HYPERTENSION AND HEART FAILURE, SMOKING CESSATION, FALLS PREVENTION, CHRONIC PAIN MANAGEMENT, NARCOTICS USE AND DIVERSION, AND IMPROVING ACCESS TO CARE.EXAMPLES OF BMC PROMOTING THE HEALTH OF THE COMMUNITY DURING FY 2024 INCLUDE BUT IS NOT LIMITED TO:1. DONATED FUNDS TO COMMUNITY EVENTS, LOCAL SPORTS TEAMS, ORGANIZATIONS, AND INITIATIVES2. HOSTED SEVERAL COMMUNITY EVENTS INCLUDING A SUPPORT GROUPS AND COMMUNITY EDUCATION, BMC INDEPENDENCE DAY RUN, BERKSHIRES 150, FOOD SERVICE DONATION TO HOMELESS SHELTERS 3. MEDICAL STUDENTS PROVIDING HEALTH EDUCATION AT COMMUNITY EVENTS.4. MEMBERS OF THE WELLNESS PROGRAM AND MANAGEMENT TEAM PROVIDING BLOOD PRESSURE SCREENINGS, HEALTH EDUCATION, ENVIRONMENTAL CLEAN UPS, AND OTHER COMMUNITY VOLUNTEERISM5. OFFERED COMMUNITY PARTNERS FREE TRAINING FOR INTERESTED EMT'S IN COLLABORATION WITH OUR COUNTY EMS AGENCIES. 6. CREATED SEVERAL TALENT PIPELINE PROGRAMS FOR MEDICAL ASSISTANTS, LPN TO RN PROGRAMS. 7. SUPPORTED 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), BLACKSHIRES (ECONOMIC AND SOCIAL ADVANCEMENT), AND Q-MOB (COMMUNITY WELLNESS). 8. 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 ARTS, BERKSHIRE IMMIGRATION CENTER.9. ASSISTED COMMUNITY AGENCIES WITH NALOXONE EDUCATION AND INSTALLATION OF NALOXONE DISPENSING CAPABILITIES.
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) 2023

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
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Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

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) 2023

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)
1DARLENE RODOWICZ PRESIDENT	(i) (ii)	0 ------------- 829,481	0 ------------- 142,617	0 ------------- 83,401	0 ------------- 13,723	0 ------------- 23,430	0 ------------- 1,092,652	0 ------------- 0
2ROBIN BURNS-LAMBERT MD ANESTHESIOLOGIST	(i) (ii)	969,263 ------------- 0	13,651 ------------- 0	5,471 ------------- 0	14,554 ------------- 0	41,100 ------------- 0	1,044,039 ------------- 0	0 ------------- 0
3SEETHA MUTHAVARAPU MD HOSPITALIST	(i) (ii)	694,027 ------------- 0	15,338 ------------- 0	2,876 ------------- 0	14,850 ------------- 0	41,521 ------------- 0	768,612 ------------- 0	0 ------------- 0
4JASON BRATCHER MD TRUSTEE/PHYSICIAN TERM BEGAN 1/24	(i) (ii)	0 ------------- 545,031	0 ------------- 93,784	0 ------------- 3,024	0 ------------- 13,832	0 ------------- 16,509	0 ------------- 672,180	0 ------------- 0
5RAYMOND GARY SOHL MD ANESTHESIOLOGIST	(i) (ii)	607,413 ------------- 0	12,539 ------------- 0	7,472 ------------- 0	14,850 ------------- 0	26,189 ------------- 0	668,463 ------------- 0	0 ------------- 0
6SCOTT ST GEORGE TREASURER	(i) (ii)	0 ------------- 498,127	0 ------------- 42,925	0 ------------- 61,450	0 ------------- 9,013	0 ------------- 16,379	0 ------------- 627,894	0 ------------- 0
7DAVID POMERANTZ MD ANESTHESIOLOGIST	(i) (ii)	513,753 ------------- 0	11,657 ------------- 0	5,433 ------------- 0	11,102 ------------- 0	54,957 ------------- 0	596,902 ------------- 0	0 ------------- 0
8ANDREW MANZER CHIEF OPERATING OFFICER	(i) (ii)	442,240 ------------- 0	38,535 ------------- 0	39,412 ------------- 0	14,850 ------------- 0	39,448 ------------- 0	574,485 ------------- 0	0 ------------- 0
9LJILJANA MARKOVIC MD CHAIR OF PSYCHIATRY	(i) (ii)	507,099 ------------- 0	10,844 ------------- 0	3,128 ------------- 0	14,324 ------------- 0	26,613 ------------- 0	562,008 ------------- 0	0 ------------- 0
10MICHAEL MCHUGH MD CHAIRMAN-E.D. MEDICINE	(i) (ii)	428,222 ------------- 0	39,716 ------------- 0	13,037 ------------- 0	14,850 ------------- 0	28,673 ------------- 0	524,498 ------------- 0	0 ------------- 0
11ALEC A BELMAN MD TRUSTEE/PHYSICIAN	(i) (ii)	0 ------------- 387,139	0 ------------- 21,463	0 ------------- 2,701	0 ------------- 14,850	0 ------------- 54,907	0 ------------- 481,060	0 ------------- 0
12BRENDA E CADORETTE CHIEF NURSING OFFICER	(i) (ii)	279,542 ------------- 0	24,698 ------------- 0	45,824 ------------- 0	11,640 ------------- 0	33,685 ------------- 0	395,389 ------------- 0	0 ------------- 0
13EDMUND HORNSTEIN DO TRUSTEE/PHYSICIAN	(i) (ii)	103,793 ------------- 221,460	0 ------------- 3,923	0 ------------- 1,799	0 ------------- 0	0 ------------- 380	103,793 ------------- 227,562	0 ------------- 0
14JOHN A LOIODICE MD TRUSTEE/PHYSICIAN	(i) (ii)	0 ------------- 238,907	0 ------------- 5,518	0 ------------- 6,211	0 ------------- 9,437	0 ------------- 28,601	0 ------------- 288,674	0 ------------- 0

Schedule J (Form 990) 2023

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 BASE COMPENSATION FOR MANAGEMENT EMPLOYEES AT THE 50TH PERCENTILE OF APPROPRIATE. IN CALENDAY YEAR 2023, COMPENSATION FOR CEO WAS AT THE 40TH PERCENTILE FOR BASE PAY.

Schedule J (Form 990) 2023

Additional Data

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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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

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 ..................	8,230,000
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) 2023

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) 2023

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) 2023

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

2023

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	25,760	FAIR MARKET VALUE
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) (2023)

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) (2023)

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

BERKSHIRE MEDICAL CENTER INC

Employer identification number

04-2791396

Return Reference	Explanation
FORM 990, PART VI	BERKSHIRE MEDICAL CENTER INC RELIES ON BHS MANAGEMENT SERVICES, INC. TO PROVIDE MANAGEMENT AND SUPPORT SERVICES FOR THE CHIEF EXECUTIVE OFFICER, CHIEF FIANCIAL OFFICER, VP GENERAL COUNSEL, VP HUMAN RESOURCES, AND VP OF PHYSICIAN SERVICES.
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 BASE 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 -36,054,962.
SCHEDULE H PART V SECTION B LINE 5	YOUTH MENTAL HEALTH THE MENTAL HEALTH CHALLENGES OF YOUTH AND YOUNG ADULTS (AGE 12-24) ARE ACUTE. ACROSS THE SERVICE AREA, YOUTH SURVEYS FROM 2021, AS WELL AS THE STATEWIDE COVID-19 IMPACT SURVEY FROM 2020, SHOW THAT THE PANDEMIC HAS WORSENED THE MENTAL HEALTH OF MANY ADOLESCENTS AND TEENAGERS, WHO EXPERIENCED GROWING ANXIETY, SADNESS, AND DEPRESSION. INEQUITIES WERE BROUGHT TO THE FORE DURING THE PANDEMIC, ESPECIALLY FOR GIRLS, BLACK AND LATINO/A/E YOUTH, YOUTH WITH A DISABILITY, LGBTQIA+, RURAL YOUTH, AND YOUNG ADULTS 18-24. ADULT MENTAL HEALTH AND SUBSTANCE USE AS WAS THE CASE IN THE 2021 CHNA, MENTAL HEALTH AND SUBSTANCE USE DISORDER CONTINUE TO BE PRIORITIZED HEALTH NEEDS ACROSS THE STATE AND BERKSHIRE HEALTH SYSTEMS' SERVICE AREA. ANY DISCUSSION OF MENTAL HEALTH AND SUBSTANCE USE DISORDER IN WESTERN MASSACHUSETTS MUST ACKNOWLEDGE THE DIVERSITY OF LIVED EXPERIENCE WITHIN THE REGION AND THIS SERVICE AREA. MENTAL HEALTH AND SUBSTANCE USE CHALLENGES EMERGE IN VARIED CONTEXTS, FROM RURAL POVERTY AND ISOLATION TO DISCRIMINATION. AMONG PUBLIC HEALTH OFFICIALS IN BERKSHIRE COUNTY SURVEYED IN 2021 FOR THIS ASSESSMENT, 36% OF RESPONDENTS OVERALL LISTED MENTAL HEALTH AND SUBSTANCE USE AS ONE OF THE MOST PRESSING HEALTH ISSUES IN THEIR COMMUNITY. A SUBSET OF THOSE RESPONDENTS ALSO CITED A SHORTAGE OF MENTAL HEALTH AND SUBSTANCE USE SERVICES. THE STATEWIDE COVID-19 COMMUNITY IMPACT SURVEY (CCIS) CONDUCTED IN 2020 REPORTED THAT IN THE BERKSHIRE HEALTH SYSTEMS SERVICE AREA, ONE IN THREE RESPONDENTS (33%) REPORTED 15 OR MORE POOR MENTAL HEALTH DAYS IN THE PAST 30 DAYS. THE RATE WAS 34% FOR RESPONDENTS THAT LIVED IN A RURAL AREA. THE QUESTION ON POOR MENTAL HEALTH DAYS IS A STANDARD ITEM FROM THE CDC BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM THAT INCLUDES STRESS, DEPRESSION, AND PROBLEMS WITH EMOTIONS. MORE THAN ONE IN FOUR RESPONDENTS (27%) REPORTED EXPERIENCING THREE OR MORE POST TRAUMATIC STRESS DISORDER (PTSD)-LIKE REACTIONS TO THE PANDEMIC, WHICH INCLUDE NIGHTMARES, AVOIDANT BEHAVIORS, GUILT, ETC. AMONG BERKSHIRE COUNTY RESPONDENTS THAT USED ANY SUBSTANCE IN THE PAST 30 DAYS, 39% INCREASED THEIR SUBSTANCE USE COMPARED TO BEFORE THE ONSET OF THE PANDEMIC. BERKSHIRE HEALTH SYSTEMS IS FOCUSED ON EXPANDING RESIDENTS' ACCESS TO CULTURALLY COMPETENT MENTAL HEALTH SERVICES AND SERVICES AIMED AT HELPING PEOPLE WITH SUBSTANCE USE DISORDER, AND MAKING THEM READILY AVAILABLE TO THEM. 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 (SEE FIGURE 24). 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	CHRONIC CONDTIONS & INFECTIOUS DISEASE CONTINUED 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 & CARE COORDINATION 1. 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. 2. 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. 3. BHS NURSE CALL LINE - THE NURSE CALL LINE HELPS PATIENTS DETERMINE WHERE THEY SHOULD GO FOR THEIR CARE-URGENT CARE, EMERGENCY CARE, PRIMARY CARE. NURSES HELP PATIENTS ON WARFARIN MANAGE THEIR MEDICATION IN COLLABORATION WITH THEIR PRIMARY CARE PROVIDER AS WELL AS HELP PEOPLE NAVIGATE THE HEALTHCARE SYSTEM AND PROVIDE ASSISTANCE WITH ACCESS TO COMMUNITY SERVICES. SOCIAL ECONOMIC 1. 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, AND MUNICIPAL GOVERNMENTS ACROSS THE COUNTY. 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, BHS HAS A COMPREHENSIVE EMERGENCY PREPAREDNESS PROGRAM. THIS PROGRAM WORKS TO IMPROVE RESPONSE TO POTENTIAL COMMUNITY EMERGENCIES THROUGH REGULAR TABLETOP AND LIVE-ACTION DRILLS. BHS'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. 2. 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. 3. 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. 4. 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. 5. 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 MAINTAINS PARTNERSHIP TO FURTHER REDUCE SOCIAL DETERMINANTS OF HEALTH BARRIERS. 6. 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. BMC WORKS IN COLLABORATION WITH THIS COMMUNITY PARTNER BY PARTICIPATING ON COMMITTEES, SHARING DATA, AND RESOURCES. WORKFORCE DEVELOPMENT 1. 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, RADIOLOGY, AND NEUROLOGY, ORTHOPEDIC SURGERY, ENDOCRINOLOGY, AND OTHERS. THIS INCLUDES NOT ONLY PHYSICIANS, BUT ALSO NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS. 2. 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. 3. CAREER PATHWAYS - BMC IS PROUD TO INVEST IN AND CULTIVATE CAREER PATHWAY PROGRAMS, OFFERING PAID TRAINING OPPORTUNITIES WHERE PROFESSIONALS ARE ABLE TO LEARN VALUABLE SKILLS, EARN CERTIFICATIONS, AND FAST-TRACK PROGRESS TOWARD A CAREER IN HEALTHCARE. CAREER PATHWAY PROGRAMS ARE PAID EDUCATIONAL OPPORTUNITIES SPECIFICALLY DESIGNED TO FOSTER A TALENTED, DIVERSE WORKFORCE BY BREAKING DOWN BARRIERS THAT HAVE TRADITIONALLY PREVENTED MANY INDIVIDUALS INTERESTED IN HEALTHCARE FROM JOINING OUR WORKFORCE. BMC IS SPECIFICALLY FOCUSED ON BUILDING PATHWAYS TO THE MOST IMMEDIATELY NEEDED ROLES: NURSING ASSISTANTS, MEDICAL ASSISTANTS, LICENSED PRACTICAL NURSES, AND REGISTERED NURSES. THIS IS ACHIEVED THROUGH PAID IN-HOUSE TRAINING PROGRAMS AND PARTNERSHIPS WITH LOCAL EDUCATIONAL INSTITUTIONS LIKE BERKSHIRE COMMUNITY COLLEGE AND MCCANN TECHNICAL SCHOOL. IN 2023, THE SYSTEM ANNOUNCED A NEW PARTNERSHIP WITH MASSACHUSETTS COLLEGE OF LIBERAL ARTS, HELPING LAUNCH A 4-YEAR BACHELOR OF SCIENCE IN NURSING PROGRAM, DESIGNED TO HELP GROW THE NEXT GENERATION OF NURSES AND HEALTHCARE PROFESSIONALS IN THE BERKSHIRES.

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

Cat. No. 51056K

Schedule O (Form 990) 2023

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	23
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	18
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	3,748
6	Total number of volunteers (estimate if necessary) .............	6	111
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	951,630
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	950,630

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,027,279	3,185,957
9	Program service revenue (Part VIII, line 2g) .........	667,315,117	723,028,187
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	28,227,291	29,392,848
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,346,960	1,883,053
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	700,916,647	757,490,045
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)	296,324,189	304,375,809
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	342,367,900	354,618,203
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	638,692,089	658,994,012
19	Revenue less expenses. Subtract line 18 from line 12.......	62,224,558	98,496,033
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	759,507,288	831,876,410
21	Total liabilities (Part X, line 26).............	223,047,643	181,058,073
22	Net assets or fund balances. Subtract line 21 from line 20.....	536,459,645	650,818,337

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 551,113,161 including grants of $ ) (Revenue $ 671,508,709 )
	OPERATE AN ACUTE CARE GENERAL HOSPITAL AND MEDICAL EDUCATIONAL FACILITY, AND DELIVER THE HIGHEST QUALITY PATIENT-CENTERED CARE IN A LEARNING ENVIRONMENT. TOTAL PATIENT DAYS FOR THE YEAR ARE 64,192, TOTAL LAB PROCEDURES 1,690,115, TOTAL RADIOLOGY PROCEDURES 178,686, TOTAL REHAB VISITS 56,383. HOURS OF OPERATION 24/HRS 365/DAYS PER YEAR.

4b	(Code: ) (Expenses $ 38,226,949 including grants of $ ) (Revenue $ 41,981,833 )
	OPERATION OF AN EMERGENCY DEPARTMENT AND TRAUMA CARE CENTER AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. TOTAL VISITS FOR THE YEAR 48,269. EMERGENCY DEPARTMENT IS IN OPERATION 24 HRS/DAY 365 DAYS/YEAR.

4c	(Code: ) (Expenses $ 12,845,583 including grants of $ ) (Revenue $ 6,967,224 )
	VISITING NURSE PROGRAM ALLOWING FOR THE CARE AND REHABILITATION OF PATIENTS IN THEIR OWN HOME ENVIRONMENT. TOTAL VISITS FOR THE YEAR 34,485 DETAILED AS FOLLOWS SKILLED NURSING 17,205 HOME HEALTH AIDE 1,077, REHAB 15,815, AND SOCIAL SERVICE 388. HOURS OF OPERATION 7 DAYS/WEEK 8AM-9PM WITH A NURSE ON CALL 24 HOURS.

	(Code: ) (Expenses $ 3,426,527 including grants of $ ) (Revenue $ 2,570,421 )
	OPERATE A SUBSTANCE ABUSE CENTER PROVIDING THE HIGHEST QUALITY OF PATIENT CARE. TOTAL PATIENT DAYS FOR THE YEAR 6,340. PROGRAM OPERATES 24 HRS/DAY 365 DAYS/YEAR.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 3,426,527 including grants of $ ) (Revenue $ 2,570,421 )
4e	Total program service expenses605,612,220

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	4,834,983	3,318,275	623,988

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	2,856,935

f	All other contributions, gifts, grants, and similar amounts not included above		1f	329,022

g	Noncash contributions included in lines 1a - 1f:$		1g	25,760

h Total. Add lines 1a-1f.......		3,185,957

		Business Code
2a	PATIENT SERVICES REVENUE	622000	583,452,699	583,452,699
b	RETAIL PHARMACY	456110	105,134,890	105,134,890
c	OTHER ANCILLARY	622000	28,939,777	28,939,777
d	LAB REVENUE	621510	3,373,660	3,373,660
e	HEALTH PROMO EDUCATION	611710	2,127,161	2,127,161
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		723,028,187

3 Investment income (including dividends, interest, and othersimilar amounts) ......			13,512,627		951,630	12,560,997
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	664,789
b	Less: rental expenses	6b	618,523
c	Rental income or (loss)	6c	46,266
d	Net rental income or (loss).......			46,266			46,266
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	17,900,432	2,899
b	Less: cost or other basis and sales expenses	7b	2,023,110	0
c	Gain or (loss)	7c	15,877,322	2,899
d	Net gain or (loss).........			15,880,221			15,880,221
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
11a	CAFETERIA INCOME		722514	1,836,787			1,836,787
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,836,787
12	Total revenue. See instructions.....			757,490,045	723,028,187	951,630	30,324,271

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 ...........	1,546,546		1,546,546
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........	239,544,476	235,518,802	4,025,674
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	9,001,254	8,762,508	238,746
9	Other employee benefits .......	34,474,315	33,888,255	586,060
10	Payroll taxes ...........	19,809,218	19,472,460	336,758
11	Fees for services (non-employees):
a	Management ......	41,902,492		41,902,492
b	Legal .........	93,230		93,230
c	Accounting ...........
d	Lobbying ...........	54,462	54,462
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	65,237		65,237
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	43,538,867	42,980,552	558,315
12	Advertising and promotion ....
13	Office expenses .......	257,263	252,889	4,374
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	6,347,565	6,239,656	107,909
17	Travel ............	646,075	635,091	10,984
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	412,345	405,335	7,010
21	Payments to affiliates .......	521,111	521,111
22	Depreciation, depletion, and amortization ..	19,084,472	18,886,435	198,037
23	Insurance ...	2,924,427	2,874,712	49,715
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	191,267,297	188,711,823	2,555,474
b	BAD DEBT	22,573,350	22,573,350
c	UNCOMPENSATED CARE POOL	12,309,252	12,309,252
d	EQUIP RENTAL/PURCHASES	11,978,246	11,447,207	531,039
e	All other expenses	642,512	78,320	564,192
25	Total functional expenses. Add lines 1 through 24e	658,994,012	605,612,220	53,381,792	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			15,596	1	15,596
2	Savings and temporary cash investments .........			146,877,847	2	139,570,794
3	Pledges and grants receivable, net ......			408,068	3	231,289
4	Accounts receivable, net .............			56,420,934	4	52,671,789
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 ...........			16,568,926	7	27,537,515
8	Inventories for sale or use ............			15,277,143	8	13,879,150
9	Prepaid expenses and deferred charges ......			3,350,283	9	4,561,524
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	500,657,770
b	Less: accumulated depreciation	10b	334,542,792	172,083,117	10c	166,114,978
11	Investments—publicly traded securities .			273,534,755	11	331,353,757
12	Investments—other securities. See Part IV, line 11 .....			49,568,812	12	67,559,592
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			25,401,807	15	28,380,426
16	Total assets. Add lines 1 through 15 (must equal line 33)...			759,507,288	16	831,876,410

17	Accounts payable and accrued expenses .....	62,190,272	17	63,311,426
18	Grants payable ...		18
19	Deferred revenue .........	3,963,415	19	9,822,394
20	Tax-exempt bond liabilities .........	44,032,760	20	38,439,880
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 ..	4,017,440	23	4,226,880
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	108,843,756	25	65,257,493
26	Total liabilities. Add lines 17 through 25..	223,047,643	26	181,058,073

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	497,111,574	27	604,796,307
28	Net assets with donor restrictions ...........	39,348,069	28	46,022,032
	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 ...........	536,459,641	32	650,818,337
33	Total liabilities and net assets/fund balances ........	759,507,288	33	831,876,410

(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
(5)NORTH ADAMS REGIONAL HOSPITAL CORPORATION 725 NORTH ST PITTSFIELD,MA01201 93-2484732	ACUTE CARE	MA	501(C)(3)	3	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