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MHA and AHA have reported to Cooley Dickinson Hospital the portion of the dues that are used for lobbying purposes on behalf of member hospitals."}]},"ScheduleD":{"endowment_funds":{"current_year":{"beginning_year_balance":3892904,"contributions":150,"investment_earnings_or_losses":125417,"grants_or_scholarships":1500,"other_expenditures":63915,"administrative_expenses":0,"end_year_balance":3953056},"current_year_minus1":{"beginning_year_balance":3913781,"contributions":10720,"investment_earnings_or_losses":30998,"grants_or_scholarships":1100,"other_expenditures":61495,"administrative_expenses":0,"end_year_balance":3892904},"board_designated_eoy_percentage":0.49,"permanent_endowment_eoy_percentage":0.13,"term_endowment_eoy_percentage":0.38,"held_by_unrelated_organizations":false,"held_by_related_organizations":true,"related_organizations_listed_schedule_r":true},"land_buildings_equipment":{"land":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":1783897,"book_value":1783897},"buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":63409955,"book_value":46699869,"depreciation":16710086},"leasehold_improvements":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":47264431,"book_value":20066969,"depreciation":27197462},"equipment":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":78168678,"book_value":14313219,"depreciation":63855459},"other_land_buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":3263719,"book_value":1915753,"depreciation":1347966},"total_book_value":84779707},"other_assets":{"assets":[{"description":"beneficial interest in assets of CDHCC","book_value":5394377},{"description":"assets whose use is limited","book_value":863954},{"description":"due from affiliates","book_value":68129},{"description":"PHO start up costs","book_value":197750},{"description":"physician loan receivable","book_value":78516},{"description":"other current assets","book_value":563449}],"total_book_value":7166175},"other_liabilities":{"federal_income_tax_liability":0,"liabilities":[{"description":"due to affiliate","amount":71944},{"description":"pension liability","amount":29084300},{"description":"estimated settlements due to 3rd parties","amount":8018891},{"description":"other liabilities","amount":2254549}],"total_liability":39429684},"net_assets_reconciliation":{"total_revenue":166513593,"total_expenses":160842964,"excess_or_deficit_for_year":5670629,"net_unrealized_gains_losses_on_investments":21801,"donated_services_and_facilities":0,"investment_expenses":0,"prior_period_adjustments":0,"other_amount":-11982944,"total_adjustments":-11961143,"excess_or_deficit_per_financial_statements":-6290514},"revenue_reconciliation":{"total_revenue_audited_financial_statements":165322929,"net_unrealized_gains_investments":0,"donated_services_and_use_facilities":0,"recoveries_prior_year_grants":0,"other_revenue":0,"revenue_not_reported":0,"revenue_subtotal":165322929,"investment_expenses_not_included":0,"other_revenues_not_included":1190664,"revenue_not_reported_financial_statement":1190664,"total_revenue_per_990":166513593},"expense_reconciliation":{"total_expenses_audited_financial_statements":160842964,"donated_services_use_facilities":0,"prior_year_adjustments":0,"losses_reported":0,"other_expenses_included":0,"expenses_not_reported":0,"expenses_subtotal":160842964,"investment_expenses_not_included":0,"other_expenses_not_included":0,"expenses_not_reported_financial_statement":0,"total_expenses_per_990":160842964},"supplemental_information":[{"identifier":"SchD_P05_S00_L04","form_and_line_reference":"Schedule D, Part V, Line 4","explanation":"The income from endowed funds is expendable to support healthcare services and nursing scholarships in furtherance of the organization's exempt mission."},{"identifier":"SchD_P10_S00_L00","form_and_line_reference":"Schedule D, Part X","explanation":"Liabilities not detailed in Form 990 Part X lines 17 through 24; due to affiliates, pension liability, estimated settlements to 3rd parties, etc. The organization did not have a FIN48 liability, therefore a footnote was not needed in the audited financial statements."},{"identifier":"SchD_P11_S00_L08","form_and_line_reference":"Schedule D, Part XI, Line 8","explanation":"Minimum pension liability adjustment, (8,154,971); Transfers to CD Practice Associates for start up operations, (4,909,366); Transfers to Cooley Dickinson Health Care Corporation for development activities, (655,905); Transfers from Cooley Dickinson Health Care Corporation to finance property and equipment, 96,591; Net assets released from restriction used for capital additions, 667,415; Change in beneficial interest, temp restricted, 987,320; Change in beneficial interest, perm restricted, (14,028)."},{"identifier":"SchD_P12_S00_L04b","form_and_line_reference":"Schedule D, Part XII, Line 4b","explanation":"Non-operating gains."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":false,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":true,"unable_to_provide_care":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":1442518,"bad_debt_expense_attributable_to_financial_assistance":544187,"reimbursed_by_medicare":37643276,"cost_of_care_reimbursed_by_medicare":46414131,"medicare_surplus_or_shortfall":-8770855,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":2956551,"direct_offsetting_revenue":897193,"net_community_benefit_expense":2059358,"total_expense_percentage":0.0131},"unreimbursed_medicaid":{"total_community_benefit_expense":15210383,"direct_offsetting_revenue":11511419,"net_community_benefit_expense":3698964,"total_expense_percentage":0.0235},"unreimbursed_costs":{"total_community_benefit_expense":4141741,"direct_offsetting_revenue":2690746,"net_community_benefit_expense":1450995,"total_expense_percentage":0.0092},"total_financial_assistance":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":22308675,"direct_offsetting_revenue":15099358,"net_community_benefit_expense":7209317,"total_expense_percentage":0.0458},"community_health_services":{"total_community_benefit_expense":4697292,"direct_offsetting_revenue":1720303,"net_community_benefit_expense":2976989,"total_expense_percentage":0.0189},"subsidized_health_services":{"total_community_benefit_expense":3790333,"direct_offsetting_revenue":3602727,"net_community_benefit_expense":187606,"total_expense_percentage":0.0012},"research":{"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"cash_and_inkind_contributions":{"total_community_benefit_expense":33024,"direct_offsetting_revenue":0,"net_community_benefit_expense":33024,"total_expense_percentage":0.0002},"total_other_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":8520649,"direct_offsetting_revenue":5323030,"net_community_benefit_expense":3197619,"total_expense_percentage":0.0203},"total_community_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":30829324,"direct_offsetting_revenue":20422388,"net_community_benefit_expense":10406936,"total_expense_percentage":0.0661}},"community_building":{"workforce_development":{"total_community_benefit_expense":89968,"direct_offsetting_revenue":0,"net_community_benefit_expense":89968,"total_expense_percentage":0.0006},"total_community_building_activities":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":89968,"direct_offsetting_revenue":0,"net_community_benefit_expense":89968,"total_expense_percentage":0.0006}},"hospital_facilities":[{"business_name_line1":"Cooley Dickinson Hospital Inc","address_line1":"30 Locust Street","city":"Northampton","state":"MA","zip":"01060","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"Cooley Dickinson Hospital Inc","address":"30 Locust Street, Northampton, MA, 01060"}],"part_vi_explanations":{"affiliated_health_care_system":"Cooley Dickinson Hospital, Inc. (the \"Hospital\") is an acute care, not-for-profit 142 bed community hospital located in Northampton Massachusetts and a wholly owned subsidiary of Cooley Dickinson Health Care Corporation (the \"Corporation\"). The Hospital provides a broad range of patient services and a number of health related community services, including acute and critical medicine, surgery, psychiatry, and rehabilitation. The Corporation provides fund raising support and maintains donor-restricted funds for the benefit of the Hospital. Other related entities of the Hospital include CD Practice Associates, Inc. (\"CDPA\"), a not-for-profit organization established to own and manage operating groups of physicians; and VNA and Hospice of Cooley Dickinson, Inc. (\"VNA/Hospice\"), a not-for-profit organization established to provide home health and hospice care services.","bad_debt_footnote":"The audited financial statements for Cooley Dickinson Hospital do not contain a footnote describing bad debt expense. The costing methodology was the ratio of patient service expense to patient service revenue from the FY2010 Massachusetts Division of Health Care Finance and Policy 403 cost report of Cooley Dickinson Hospital.","community_building_activities":"The challenge exists within healthcare of recruiting and retaining qualified nursing staff. An effective strategy requires a number of interventions including: 1) ensuring a continual pool of new nurses to replace our rapidly aging Nursing workforce; 2) developing mechanisms to attract and recruit new nurse graduates; 3) developing the current nursing workforce to meet care delivery demands; 4) creating systems and a culture that recognizes and supports the development of professional nursing practice so that we can retain our most expert nurses. In an effort to overcome this challenge, The University of Massachusetts School of Nursing (UMASS) has doubled its undergraduate enrollment and is committed to increasing the enrollment in the RN/BS and 2-Bachelor's programs between 2008 and 2010. To meet the increased faculty and clinical demand UMASS and Cooley Dickinson Hospital developed a workforce collaboration to formalize and strengthen the practice/education partnership between the two institutions, meeting the needs of both institutions and the community. Cooley Dickinson Hospital funded one full time UMASS faculty position and supported the contract faculty pool.","community_information":"Cooley Dickinson Hospital (CDH) serves a population (2010) of 122,180 residents of Hampshire and Franklin counties in the Pioneer Valley region of Massachusetts. Its primary service area (PSA) is comprised of fifteen Hampshire and one Franklin community and secondary service area (SSA) of five Hampshire and six Franklin communities. The area is suburban and rural; home to several colleges and the state university; and within a region known for farming, the arts, outdoor activities, and small businesses. The PSA includes the following communities from which 50 percent or more of inpatient hospital admissions were to CDH for the three years from fiscal 2007 through fiscal 2009: Amherst; Chesterfield; Cummington; Easthampton; Florence; Goshen Hadley; Hatfield; Haydenville; Leeds; North Amherst; North Hatfield; Northampton; West Hatfield; Whately; Williamsburg. The following communities, from which 25 percent of more of inpatient hospital admissions were to CDH for the three-year period, comprise the SSA: Ashfield; Buckland; Huntington; Leverett; Plainfield; Shutesbury; South Deerfield; Southampton; Sunderland; West Chesterfield; Worthington. The population of the primary service area is expected to decline by 0.17 percent in 2015, while growth of 0.43 percent is expected for the secondary service area. Aging; The service area is graying, consistent with national trends. This will increase demand for hospital services. * 12.3 percent of the PSA population and 12.42 percent of the SSA was 65 or older in 2010. These rates are lower than for Massachusetts (13.3 percent) as a whole, but close to the U.S. rate of 12.6 percent. (By 2015, 14 percent of the PSA population and 15 percent of the SSA is expected to be 65+) * The age cohorts closest to retirement age show the biggest changes among area residents, (By 2015, the population of 65-74-year-olds is projected to grow by 30 percent in the PSA and 34 percent in the SSA) (18 percent growth is expected for 60-64-year-olds in both the PSA and SSA) * The number of residents in the combined primary and secondary service areas 85 and older is projected to increase by almost 8 percent to 2,904 residents. Income; The communities Cooley Dickinson serves have higher median household incomes than either Hampshire or Franklin county as a whole. PSA household income in 2000 (the last year for which data for all PSA communities is available) averaged $47,069; SSA, $49,099. These levels are below that for Massachusetts at the time, $50,502. Race and Ethnicity; Eighty-seven percent of PSA residents and 94 percent of SSA residents are white, according to 2010 population estimates. The percentages are expected to decline by 2015. The next largest group is Asian, which is expected to be 4.85 percent of the PSA population by 2015 and 2.59 percent of the SSA population. A change in the population of note is an expected increase by 11 percent to 6,096 of the Hispanic population in the primary service area and an 8 percent increase to 418 in the secondary service area. In the PSA, that growth will shift the percentage of Hispanic population to 6.2 percent by 2015 as the non-Hispanic population declines. Cooley Dickinson Hospital spent over $321,000 on medical interpreter services during the year to assist non-English speaking patients. Educational Attainment; Cooley Dickinson serves a population with higher levels of educational attainment than Massachusetts and the nation. Fifty percent of PSA residents have a college degree or higher, compared to 38 percent for Massachusetts and 27 percent U.S. Employment; Not surprisingly given the educational attainment of residents of the service area, the occupational makeup of the population differs dramatically from that of the nation. Educational services and health care are the largest employment sectors in the primary and secondary service areas. The following compares the percentage of the population employed in the top three occupational groups for the service area with the overall U.S. rates for the same groups; Education-5.7% US, 31.3% PSA, 19.84% SSA; Health care-6.6% US, 14.6% PSA, 16.13% SSA; Sales/office-26.7% US, 11.83% PSA, 13.65% SSA. Four hospitals and three educational institutions are among the top 15 employers in the Pioneer Valley, according to Economic Development Data & Information for Connecticut & Western Massachusetts. Employment is stable historically, Hampshire County's unemployment rate reached its highest rate since 1992 in January 2010 and remained high through the end of the fiscal year. This, and changes in the insurance status of the population, has prevented some residents from seeking care. Recession Impact; Despite that the CDH service area income is relatively high, a snapshot of data from the Massachusetts Division of Insurance shows the economy slowdown has affected the insurance coverage that area residents carry. Data indicate a shift from commercial HMOs and the Commonwealth Connector program to Medicaid. Overall enrollment in HMOs dropped by 2 percent in Hampshire County to 51,916 and by 4 percent in Franklin to 27,247 between 2009 and 2010. Access to Care; Cooley Dickinson is one of two not-for-profit hospitals in Hampshire County. The second, Baystate Mary Lane Hospital, is 50 minutes to 1 hour driving time away from Cooley Dickinson. Baystate also has facilities about 30 minutes away in northern Franklin County's Greenfield and south of the Cooley Dickinson service area in Hampden County's Springfield. The U.S. Health Resources and Services Administration has designated three communities in Cooley Dickinson's primary service area and five in the secondary service area as Medically Underserved Areas (MUAs). A corporate affiliate, CD Practice Associates, employes two primary care physicians and a nurse practitioner in one of the MUAs, Williamsburg, and the hospital provides rehabilitation services in another, Worthington. Massachusetts' health insurance mandate means the percentage of uninsured residents in the service area is low. Nevertheless, the hospital provides a safety net for the uninsured and underinsured through some use of the emergency department for primary care and actively seeks to enroll patients and residents in coverage through Hampshire Health Connect. Preliminary health assessment findings show that cancer and heart disease are the leading causes of death (consistent with national trends). The hospital's service area is generally considered healthier than average, as described on the United States County Health Rankings website (http://www.countyhealthrankings.org/). A deep look at the data reveals increasing obesity rates, increasing diabetes rates, disparities in asthma prevalence (based on location). Compared to other communities, the data are not remarkable. But, compared to best practices, the health assessment is beginning to reveal opportunities for community change.","costing_method_used":"The costing methodology used was the ratio of patient service expense to patient service revenue from the FY2010 Massachusetts Division of Health Care Finance and Policy 403 cost report of Cooley Dickinson Hospital.","debt_collection_policy":"Cooley Dickinson Hospital will not bill patients enrolled in MassHealth, patients receiving governmental benefits under the Emergency Aid to the Elderly, Disabled and Children program, or participants in the Healthy Start program except that the Hospital may bill patients for any co-pays and deductibles required under the program of assistance. Participants in the Children's Medical Security Plan (CMSP) whose Family Income is equal to or less than 400% of the Federal Poverty Level (FPL) are also exempt from Collection Action. Low Income Patients are exempt from Collection Action for any Eligible services received during the period in which they are determined to be Low Income Patients and eligible for payment by the Health Safety Net, except for co-pays and deductibles. Cooley Dickinson Hospital will not undertake a Collection Action against an individual that has qualified for Medical Hardship under the Massachusetts Health Safety Net program with respect to the amount of the bill that exceeds the Medical Hardship contribution. The hospital will further cease any collection efforts against an emergency bad debt claim that is approved for Medical Hardship under the Health Safety Net program.","general_explanation":"Schedule H; Part I; Line 6 The organization's Community Benefit Report is filed annually with the Massachusetts Attorney General and is open to public inspection. Further, the Report is available to the public upon request.","income_based_criteria":"Service recovery activities occassionally include discounted care.","needs_assessment":"Cooley Dickinson Hospital designates the Healthy Communities Committee to oversee the assessment. The Committee is a Board committee and includes board members, staff, and community representatives. The health assessment project is staffed by the Western Massachusetts Center for Healthy Communities, a program of Cooley Dickinson Hospital. There are two main goals of the committee, with respect to the assessment; 1) Evaluate existing community programs; 2) Assess community needs and design programming and interventions based on findings. The Committee confirmed the major categories for community benefit programs as follows: Health access; Healthy equity; Healthcare reform; Chronic disease; Behavioral Health; Healthy eating and active living. Programs within these categories were reviewed and scored with regard to criteria such as fit with healthy communities mission, hospital's service area, clinical priorities, community need, focus on a specific target population (e.g. uninsured, elderly, poor, racial, linguistic, ethnic minority, etc.). Each program was asked to complete a detailed questionnaire about program operations and outcomes and met with two or three committee members to review and discuss the responses. The committee rank ordered programs based on the above criteria and made decisions about priorities for continued inclusion as a community program. The other major focus for the year was on the design of a comprehensive community health assessment. The rationale selected for the design of the assessment is that chronic diseases account for 70% of all deaths in the nation, whereas diabetes, heart disease, and certain types of cancer are largely preventable with changes in lifestyle and behavior. Further, the committee oriented the assessment to focus on the social determinants of health because research shows that behavior is influenced by environmental conditions such as local policy, systems, and culture. Social determinants may include housing, access to services and transportation, affordability of healthy food, quality of education, and so on. The design for the health assessment included several stages. In phase one, staff developed a protocol for collecting secondary data through existing local, state, and national databases. The design for phase one included a section on demographics, then sections organized around traditional health indicators such as infant mortality as well as non traditional indicators such as access to transportation. The committee confirmed broad goals within 10 categories. The categories are listed below, along with an example of an indicator: Education (e.g. improve school wellness); Economic and employment (e.g. increase food security); Housing (e.g. increase community gardens located in low income housing); Transportation (e.g. create complete streets policies, so that streets & sidewalks are designed in ways that support pedestrian use); Food System (e.g. improve access to local foods); Fitness system (e.g. increase perception of safety); Alcohol (e.g. decrease access to alcohol and other drugs); Tobacco (e.g. decrease access to tobacco products); Health outcomes (e.g. reduce incidence of chronic disease); Public health prevention and healthcare (e.g. increase routine screenings as recommended by the Centers for Disease Control). The committee reviewed various drafts of the assessment report as it was developed to provide feedback and guidance on the creation of a document. Drafts at various stages of development were also provided to hospital managers and the Massachusetts Department of Public Health and select community agencies to provide feedback and recommendations. In phase two, the health assessment design includes collecting primary data using qualitative methods such as surveys, interviews, meetings, and events. In 2010, the focus for qualitative data collection was a community survey. The survey included broad questions about health related behavior and social determinants, but the emphasis was on healthy eating and active living. The survey was designed based on materials created by Western Massachusetts Center for Healthy Communities staff for a similar project. The survey design was reviewed by faculty at the University Of Massachusetts School Of Public Health. Local youth were selected to participate in a summer program to implement the survey. They were trained to conduct the survey, provided a stipend for their time, and trained to present the results at a future community forum. As fiscal year 2010 concluded, the community health assessment was in progress, but not yet complete. The various drafts were made public on a limited basis for the purposes of obtaining feedback. The intent was to make the report fully available to the public through community forums as well as the hospital's website, and through local media.","other_information":"Cooley Dickinson Hospital's mission, \"To provide our patients and communities with the best health care in the most appropriate environment,\" is carried out by more than 1,600 employees, including 325 nurses, 416 volunteers, and 395 physicians. Together, they cared for 80,500 community members in the year ending Sept. 30, 2010. The medical staff of Cooley Dickinson is organized in the public interest. Medical staff privileges are available to all qualified physicians in the community for all of our departments. In addition, the hospital furthered its exempt purpose through partnerships with our affiliated organization, VNA & Hospice of Cooley Dickinson, and community organizations, ranging from Aging Services Access Points and Councils on Aging to long-term care facilities and boards of health. With these partnerships, we worked toward achieving the best health care through projects such as coordinating care for residents with complex medical and psychosocial issues to improve the quality of life of those residents and prevent their avoidable use of health care services. These partnerships are in addition to those created through the processes of assessing community health needs and developing and implementing our community benefits plan. Surplus funds the hospital generates are reinvested in facilities and equipment to meet the healthcare needs of the community, promote improved health, or prevent illness or injury. For example, in 2010, the hospital invested surplus funds to purchase automated patient lift equipment that prevents injury to patients and employees in the process of transfers, such as from bed to chair. Cooley Dickinson focuses on responsiveness to the healthcare needs of our community. When surveyed in 2010, residents report we succeed at that goal, rating us 3.55 on a 4.0 scale on how well we respond to needs. Strong community involvement in our organization is also demonstrated by the fact that 71 percent of the 24-member Board of Trustees are independent. In addition, other residents are involved as volunteers through the Board of Trustees' Healthy Communities and Development and Public Relations Committees. A Patient Family Advisory Council, consisting of additional residents, is involved in decisions regarding their non-profit community hospital.","patient_education_assistance":"Cooley Dickinson Hospital posts signs in the inpatient, clinic, and emergency admissions/registration areas and in business office areas that are customarily used by patients that conspicuously inform patients of the availability of financial assistance programs and the Hospital location at which to apply for such programs. All signs and notices are translated into English and Spanish. The signs notify patients of the availability of financial assistance and of other programs of public assistance. Hampshire HealthConnect (HHC), a Cooley Dickinson Hospital based program, has a mission to help uninsured and underinsured people access health coverage and care. HHC case managers assist uninsured patients to enroll with MassHealth, Health Safety Net and other state healthcare programs. HHC also administers the Hampshire Health Physician Network, a group of local physicians who offer health care to local residents who are low income and cannot qualify for MassHealth or other health insurance. Participating physicians agree to accept reduced fees and are not reimbursed by the Health Safety Net for their services. HHC flyers are distributed to all self pay patients in the emergency department and throughout the Hospital. The Hospital provides an individual notice of the availability of financial assistance programs, including Medical Hardship, to patients expected to incur charges. The Hospital will include a notice about eligible services to Low Income Patients and programs of public assistance in its initial bill and in all written collection actions stating: \"If you are unable to pay this hospital bill, you may be eligible for coverage through a financial assistance program. Enrollment in many programs is time-sensitive, so please contact our Hampshire HealthConnect Department as soon as possible. Please call 413-582-2848\". In addition, the CDH telephone representative also refer patients to HHC upon learning of their self pay status and an expressed need for assistance.","percent_of_total_expense":"Bad debt expense totaling $3,257,719 is included in Form 990, Part IX, line 25, column A, but pursuant to IRS instruction, has been excluded from the expense figure for the purpose of calculating the percentage of total expenses in Schedule H, Part I, line 7, column (f).","reports_filed_with_states":"MA","shortfall_as_community_benefit":"The full unsubsidized cost of providing care to Medicare patients should be included as a community benefit. The source for line 6 is the Cooley Dickinson Hospital FY2010 Medicare Cost Report."}},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":31772,"reported_domestic_individual_grants":0,"reported_domestic_org_grants_program_services":31772,"reported_domestic_individual_grants_program_services":0,"total_501c3_and_government_organizations":1,"total_other_organizations":0,"grants":[{"ein":46001406,"cash":31772,"purpose":"coordination of mental health services in the schools","address_line1":"212 Main Stret","city":"Northampton","state":"MA","zip":"01060","name":"Northampton Public Schools","address":"212 Main Stret, Northampton, MA, 01060"}],"total_domestic_grants":31772,"total_domestic_program_services":31772,"detail_org_grants_total":31772,"detail_domestic_grants_total":31772,"supplemental_information":[{"identifier":"SchI_P01_S00_L02","form_and_line_reference":"Schedule I, Part I, Line 2","explanation":"The grant recipient provided a presentation to the Board of Trustees Subcommittee for Healthy Communities. Recipients are also expected to submit a written annual report to the Committee."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"The grant recipient provided a presentation to the Board of Trustees Subcommittee for Healthy Communities. 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statements."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":false,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":1463754,"bad_debt_expense_attributable_to_financial_assistance":521654,"reimbursed_by_medicare":41745194,"cost_of_care_reimbursed_by_medicare":41971910,"medicare_surplus_or_shortfall":-226716,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":2800445,"direct_offsetting_revenue":515779,"net_community_benefit_expense":2284666,"total_expense_percentage":0.0152},"unreimbursed_medicaid":{"total_community_benefit_expense":14682797,"direct_offsetting_revenue":12285751,"net_community_benefit_expense":2397046,"total_expense_percentage":0.016},"unreimbursed_costs":{"total_community_benefit_expense":4496674,"direct_offsetting_revenue":3377476,"net_community_benefit_expense":1119198,"total_expense_percentage":0.0075},"total_financial_assistance":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":21979916,"direct_offsetting_revenue":16179006,"net_community_benefit_expense":5800910,"total_expense_percentage":0.0387},"community_health_services":{"total_community_benefit_expense":1813477,"direct_offsetting_revenue":380988,"net_community_benefit_expense":1432489,"total_expense_percentage":0.0095},"health_professions_education":{"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"subsidized_health_services":{"total_community_benefit_expense":4382577,"direct_offsetting_revenue":3370591,"net_community_benefit_expense":1011986,"total_expense_percentage":0.0067},"total_other_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":6196054,"direct_offsetting_revenue":3751579,"net_community_benefit_expense":2444475,"total_expense_percentage":0.0162},"total_community_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":28175970,"direct_offsetting_revenue":19930585,"net_community_benefit_expense":8245385,"total_expense_percentage":0.0549}},"community_building":{"health_improvement_advocacy":{"total_community_benefit_expense":18635,"net_community_benefit_expense":18635,"total_expense_percentage":0.0001},"total_community_building_activities":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":18635,"direct_offsetting_revenue":0,"net_community_benefit_expense":18635,"total_expense_percentage":0.0001}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"Cooley Dickinson Hospital Inc","address_line1":"30 Locust Street","city":"Northampton","state":"MA","zip":"01060","website":"cooley-dickinson.org","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"Cooley Dickinson Hospital Inc","address":"30 Locust Street, Northampton, MA, 01060"}],"facility_policies":[{"business_name_line1":"Cooley Dickinson Hospital Inc","facility_number":1,"chna_conducted":true,"community_definition":true,"community_demographics":true,"how_data_obtained":true,"community_health_needs":true,"other_health_issues":true,"community_health_needs_identification_process":true,"consulting_process":true,"chna_conducted_year":13,"took_into_account_others_input":true,"chna_conducted_with_other_facilities":true,"chna_report_widely_available":true,"report_available_on_own_website":true,"paper_copy_public_inspection":true,"implementation_strategy_adopted":true,"strategy_posted_website":true,"organization_incurred_excise_tax":false,"adopt_budget":true,"all_needs_addressed":false,"eligibility_criteria_explained":true,"fpg_family_income_limit_free_discounted":true,"fpg_family_income_limit_free_care_percentage":200.0,"fpg_used_determine_discounted_care":false,"basis_explained":false,"application_financial_assistance_explanation":true,"other_method_used":true,"includes_publicity_measures":true,"fap_available_on_website":true,"fap_available_on_request_no_charge":true,"fap_actions_on_nonpayment":true,"attached_to_invoice":true,"posted_in_admission_office":true,"posted_in_emergency_room":true,"provided_on_admission":true,"collection_activities":false,"nondiscriminatory_emergency_care_policy":true,"amounts_generally_billed":false,"gross_charges":false,"prioritize_health_needs":true,"name":"Cooley Dickinson Hospital Inc"}],"supplemental_information":[{"form_and_line_reference":"Schedule H, Part I, Line 3c","explanation":"Service recovery activities occasionally include discounted care."},{"form_and_line_reference":"Schedule H, Part I, Line 7","explanation":"The costing methodology used was the ratio of patient service expense to patient service revenue from the FY2013 Massachusetts Division of Health Care Finance and Policy 403 cost report of Cooley Dickinson Hospital"},{"form_and_line_reference":"Schedule H, Part I, Line 7f","explanation":"Bad debt expense totaling $3,663,291 is included in Form 990, Part IX, line 25, column A, but pursuant to IRS instruction, has been excluded from the expense figure for the purpose of calculating the percentage of total expenses in Schedule H, Part I, line 7, column (f)."},{"form_and_line_reference":"Schedule H, Part II","explanation":"Cooley Dickinsons vision is to make the the Pioneer Valley the nations model healthy community. One step toward making that vision real is to include consumer friendly, preventive, screening, or general health information in every issue of the The Pulse newsletter that the hospital publishes. Some of the health information is linked to the communitys health status. For example, the incidence of stroke is higher among men and women in both Hampshire and Franklin counties yet are below the Massachusetts average for the majority of years between 1999 to 2008. In 2013, one issue of The Pulse told the story of an Easthampton womans efforts to overcome the effects of a stroke. Reporting also included a checklist for stroke risk factors (Stroke: Could I Be at Risk?). An infographic outlined facts related to stroke and reminded readers that up to 80 percent of strokes can be prevented by controlling these risk factors. Finally, Cooley Dickinson repurposed stroke.orgs FAST messaging to highlight stroke symptoms and warning signs. Providing preventive health and community education is also an important objective of the Pulse. In 2013, parents were offered reminders about keeping their children healthy and safe during the winter months. Readers had access to an online quiz to test their knowledge about bike helmets and bike safety. And they learned about the Cooley Dickinson:Massachusetts General Hospital collaboration through lectures that features advances in treatment and health care delivery, health policy issues of the day, and medical research. (There were seven lectures in 2013 and five were promoted in The Pulse in addition to other media. Finally, consumer research reflects a trend of increased readership, especially since the distribution of The Pulse changed from newspaper insert to direct mail. In the most recent research, nearly a quarter of respondents are aware of the newsletter and, among those, 49 percent of the consumers said they read all, most, or some of the publication"},{"form_and_line_reference":"Schedule H, Part III, Section A, Line 4","explanation":"Cooley Dickinson Hospital, Inc. is included in the consolidated audited financial statements of Partners HealthCare System, Inc. and Affiliates. The footnote in the Partners HealthCare consolidated audited financial statements reads: In addition to free care and inadequate funding from the Medicaid and Medicare programs, there are significant losses related to self pay patients who fail to make payment for services rendered or insured patients who fail to remit copayments and deductibles as required under the applicable health insurance arrangement. The provision for bad debts of $102,409,000 in 2013 and $123,725,000 in 2012 represents charges for services provided that are deemed to be uncollectible. The estimated cost of providing these services was approximately $38,205,000 and $39,936,000 for 2013 and 2012, respectively."},{"form_and_line_reference":"Schedule H, Part III, Section B, Line 8","explanation":"The full unsubsidized cost of providing care to Medicare patients should be included as a community benefit. The source for line 6 is the Cooley Dickinson Hospital FY2013 Medicare Cost Report."},{"form_and_line_reference":"Schedule H, Part III, Section C, Line 9b","explanation":"The Hospital will not bill patients enrolled in MassHealth, patients receiving governmental benefits under the Emergency Aid to the Elderly, Disabled and Children program, or participants in the Healthy Start program except that the Hospital may bill patients for any co-pays and deductibles required under the program of assistance. The Hospital may initiate billing for a patient who alleges that he or she is a participant in any of these programs but fails to provide proof of such participation (including receipt or verification of signed application). Upon receipt of satisfactory proof that a patient is enrolled in any of the above listed programs, or receipt of the signed application, the Hospital shall cease its collection activities. Participants in the Childrens Medical Security Plan (CMSP) whose Family Income is equal to or less than 400% of the Federal Poverty Level (FPL) are also exempt from Collection Action. The Hospital may initiate billing for a patient who alleges that he or she is a participant in the CMSP, but fails to provide proof of such participation. Upon receipt of satisfactory proof that a patient is a participant in the CMSP, the Hospital shall cease all collection activities.Low Income Patients are exempt from Collection Action for any Eligible services received during the period in which they are determined to be Low Income Patients and eligible for payment by the Health Safety Net, except for co-pays and deductibles. Low Income Patients with Family Income between 201 to 400% of the FPL are exempt from Collection Action for the portion of his or her Hospital bill that exceeds the deductible except for Health Safety Net co-payments and deductibles as set forth in 114.6 CMR 13.04. The Hospital may bill for services received outside of the period in which they are determined to be Low Income Patients. The Hospital may bill Low Income Patients for services rendered prior to the Low Income Patient determination, provided that the current Low Income Patient status has been terminated, expired, or not otherwise identified on the state Virtual Gateway or Eligibility Verification System. The Hospital 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 patients prior written consent to be billed for the service. The Hospital may not undertake a Collection Action against an individual that has qualified for Medical Hardship under the Massachusetts Health Safety Net program with respect to the amount of the bill that exceeds the Medical Hardship contribution. The Hospital will further cease any collection efforts against an emergency bad debt claim that is approved for Medical Hardship under the Health Safety Net program. The Hospital 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, provided that the state of Massachusetts will file its own recovery action for those patients enrolled in MassHealth or the Health Safety Net. The Hospital complies with all applicable billing requirements including those in the Department of Public Health regulations (105 CMR 130.332) for non payment of services or readmissions that the Hospital determines to be a result of a Serious Reportable Event (SRE). SREs that do not occur at the Hospital are excluded from this determination of non-payment. Additionally, the Hospital does not bill low income patients eligible for the Health Safety Net when claims are denied by an insurance company as a result of an administrative billing error by the Hospital."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 3","explanation":"When we conducted our most recent CHNA, we solicited input from community members in several ways. We collected data from community members through an on-line and paper-based survey intended to capture needs in broad categories for further study. The survey was not designed nor intended to be scientifically based (i.e. random respondents). The number of responses, 962, was higher than we had expected. The survey identified gaps in the care system for vulnerable populations such as people living in poverty and people whose primary language is not English. The survey also found gaps in services for the mentally ill and people with substance use disorders. The survey also confirmed concerns we had about higher than expected rates of heart disease and cancer in one community. We interviewed several community leaders to learn about their key concerns and to identify themes. Based on the survey and key informant interview findings, coupled with our earlier report about health status indicators, we conducted three focus groups: health access (including transportation); mental health, Easthampton health issues. Focus group participants were recruited from a range of places and were typically community members who use services. Based on focus group feedback, we next conducted three community forums on these topics. The forums allowed for open discussion between residents, service recipients, and agency representatives to refine findings and shape next steps. We collaborated with local health department directors and agency directors. The consulted organizations include: Amherst Health Department; Easthampton Health Department; Ambulatory Care Physicians at CDH, Inc.; Valley Medical Group; Community Action; Clinical & Support Options; Stavros; Tapestry; Highland Valley Elder Services; Northampton Survival Center; Amherst Survival Center; ServiceNet; National Alliance for the Mentally Ill, Western Massachusetts; and Easthampton Community Center."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 4","explanation":"We worked with six other hospitals in the Pioneer Valley to develop the CHNA and we all used the same survey instrument and methods. We hired our own consultants to conduct key informant interviews and focus groups. The hospitals all collaborated to produce a video showing the benefits of forming a partnership to conduct a regional health assessment. The hospitals all also agreed to develop one regional project together. The other facilities are: Baystate Medical Center, Baystate Franklin Medical Center, Baystate Mary Lane Hospital, Holyoke Medical Center, Mercy Medical Center, and Wing Memorial Hospital."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 7","explanation":"We addressed most of the needs identified in the CHNA, including all of the major ones. We did not address asthma. Asthma rates, in our earlier CHNA, appeared to be higher than expected in some schools in some communities. Upon further investigation we have discovered that the accuracy of school-based reporting varies considerably and that the data are of limited value. Asthma was not chosen as a priority for further action in part based on the uncertainty about the data. When and if reporting is more standardized and uniformly reliable, our next CHNA may show asthma as an important issue to address. The primary needs that were revealed through the CHNA that are addressing with a range of community partners are: health access; health access for the Latina population; transportation and access to health services; gaps and lack of coordination in the mental health/addiction community continuum of care; youth substance abuse; and the need to assist Easthampton to improve rates of healthy eating/active living and reduce rates of tobacco use."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 11","explanation":"The Hospital does not have a discounted care policy."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 18","explanation":"The Hospitals billings and collections did not engage in any actions such as reporting to credit agencies, lawsuits, liens on residences, body attachments, or other similar actions."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 20","explanation":"The Hospital charges all patients uniformly regardless of insurance coverage. For patients that are FAP eligible, the only bill they will receive from the Hospital is the amount due as determined by the insurance program that they qualify for through the state."},{"form_and_line_reference":"Schedule H, Part VI, Line 2","explanation":"Cooley Dickinson Hospital assesses the needs of the communities we serve using several methods. We compiled a report of health status indicators covering chronic disease, demographics, birth and death, substance abuse, food and fitness, and access to care. We published this report in 2011. The report includes detailed data including mortality, life expectancy at birth, infant mortality, low birth weight, and teen birth rate. It also includes cancer (breast, prostate, lung, and colon), asthma, cholesterol screening, diabetes, heart disease, high blood pressure, stroke and perceptions of health. In 2013 we joined other agencies to compile a report, State of the Pioneer Valley, showing indicators for children and youth, elderly, education, health and safety, economic security, housing, civics, arts and recreation, and the environment. We provided funding for the project, served as expert reviewers for the health and environmental sections, and distributed copies to key leaders. We also reviewed and included in the assessment the Hampshire Prevention Needs Assessment Survey results, showing youth behavior and risk and protective factors. Data include 30 day past use of alcohol, marijuana, and other drugs among 10th and 12th graders, youth binge drinking, and tobacco use. In 2013, we coordinated with other hospitals in the geographic area to survey residents in the region about health care issues including access to care, transportation barriers to care, food and fitness, and other topics. The other hospitals are: Holyoke Medical Center, Wing Memorial Hospital, Mercy Medical Center, Baystate Medical Center, Baystate Mary Lane Hospital, and Baystate Franklin Medical Center. We interviewed key leaders including public health and health care providers. We analyzed the interviews, surveys and indicator reports and identified key themes (health access, transportation, heart disease and cancer rates in Easthampton, mental health continuum of care, Latino health access, and youth substance abuse). We conducted focus groups on the following topics: health access; mental health; and heart disease and cancer rates in Easthampton. We conducted community forums on the same topics. The Healthy Communities Committee, a subcommittee of the Board of Trustees, approved a community benefits plan and budget for FY14 based on the needs assessment results. We have published the health assessment documents and community benefits plan on our website and presented at various community meetings."},{"form_and_line_reference":"Schedule H, Part VI, Line 3","explanation":"Cooley Dickinson Hospital posts signs in the inpatient, clinic, and emergency admissions and registration areas and in business office areas that are customarily used by patients that conspicuously inform patients of the availability of financial assistance programs and the Hospital location at which to apply for such programs. All signs and notices are translated into English and Spanish. The signs notify patients of the availability of financial assistance and of other programs of public assistance. Hampshire HealthConnect (HHC), a Cooley Dickinson Hospital based program, has a mission to help uninsured and underinsured people access health coverage and care. HHC case managers assist uninsured patients to enroll with MassHealth, Health Safety Net and other state healthcare programs. HHC also administers the Hampshire Health Physician Network, a group of local physicians who offer health care to local residents who are low income and cannot qualify for MassHealth or other health insurance. Participating physicians agree to accept reduced fees and are not reimbursed by the Health Safety Net for their services. HHC flyers are distributed to all self pay patients in the emergency department and throughout the Hospital. The Hospital provides an individual notice of the availability of financial assistance programs, including Medical Hardship, to patients expected to incur charges. The Hospital will include a notice about eligible services to Low Income Patients and programs of public assistance in its initial bill and in all written collection actions stating: If you are unable to pay this Hospital bill, you may be eligible for coverage through a financial assistance program. Enrollment in many programs is time sensitive, so please contact our Hampshire HealthConnect Department as soon as possible. To speak with someone in the Hampshire HealthConnect Department, please call (877) 429-0695, Monday through Friday 9:00 am to 5:00 pm. You may also obtain information at the Cashier's Office located in the main entrance of the Hospital."},{"form_and_line_reference":"Schedule H, Part VI, Line 4","explanation":"Cooley Dickinson Hospital CDH serves a population 2013 of 138,934 residents of Hampshire and Franklin counties in the Pioneer Valley region of Massachusetts. Its primary service area (PSA) is comprised of fifteen Hampshire and one Franklin community and secondary service area (SSA) of five Hampshire and six Franklin communities. The PSA includes the following communities from which 50 percent or more of inpatient hospital admissions were to CDH for the three years from fiscal 2009 through fiscal 2011. Amherst, Chesterfield, Cummington, Easthampton, Florence, Goshen, Hadley, Hatfield, Haydenville, Leeds, North Amherst, North Hatfield, Northampton, West Hatfield, Whately, Williamsburg. The following communities, from which 25 percent of more of inpatient hospital admissions were to CDH for the three year period, comprise the SSA. Belchertown does not meet the 25 percent share threshold, but is included because it has the seventh highest volume of discharges. Ashfield, Belchertown, Huntington, Leverett, Plainfield, Shutesbury, South Deerfield, Southampton, Sunderland, West Chesterfield, and Worthington. Population Trends Overall; The PSA population is expected to increase by 0.45 percent by 2018, with growth of 1.23 percent projected for the SSA, according to population data from ESRI Business Information Solutions. This projected stability follows a period of growth, by 4.67 percent, of the SSA population between 2000 and 2010. Factors of interest in planning hospital services and projecting use of hospital services are highlighted below. Aging; The service area is graying, consistent with national trends. *13.2 percent of the PSA population and 14 percent of the SSA was 65 or older in 2013. These rates are consistent with the 2010 rates for Massachusetts 13.8 percent and the United States 13 percent. (By 2018 16 percent of the PSA population and 15.64 percent of the SSA is expected to be 65 and older). *The age cohorts starting at traditional retirement age 65 are growing the fastest. The compound annual growth rate for area residents 65 to 79 from 2013 to 2018 is 4.86 percent in the primary service area and 5.77 percent in the secondary service area. (This means that by 2018, there will be 2,488 more 65 to 79 year olds in the PSA and 1,346 more in the SSA). *The number of residents in the primary and secondary service areas at the upper end of the age spectrum is also expected to grow but at lower rates. The population age 80 and older will grow 1.65 between 2013 and 2018, amounting to 86 more adults 80 or older, with the majority 50, in the SSA by 2018. *Children; The population up to age 14 will decline by 2018, amounting to 552 fewer children (306 from PSA and 246 from SSA). The decline in the population under 24 is not surprising given lower birth rates in our service area. Rates are reported by the Massachusetts Department of Public Health for the state and state defined community health network areas in our region. The Franklin rate of 9.2 and the Hampshire rate of 7.3, the lowest among Massachusetts community health networks in 2010, are below the Massachusetts rate of 11.1. Demographic Profile of Service Area: Income; The communities Cooley Dickinson serves have a broad range of median household incomes. ESRI data shows that the US median household income for 2013 was $54,718, close to the Cooley Dickinson Primary Service Areas $53,797. The Secondary Service Area median household income at $70,496 is closer to the Massachusetts rate of $68,185 than the PSA income. The range of median household incomes in the PSA in 2013 was from $20,000 in the Amherst 01003 zip code to $75,876 in Haydenville the SSA ranged from $42,516 in Sunderland to $83,106 in Southampton. The US census estimates that in 2012 11 percent of Massachusetts residents lived below the poverty level, with rates of 11.9 percent in Hampshire County, 13.5 percent in Northampton 5.8 percent in Easthampton and 30.5 percent in Amherst. The toll of the recession is evident here the 2000 Census reported the percentages of people living below the poverty level as 6.7 in Massachusetts and 9.2 in the nation."},{"form_and_line_reference":"Schedule H, Part VI, Line 4 Cont","explanation":"Race and Ethnicity: The Census Bureau has developed a Diversity Index to compute the differences in diversity among populations. The Diversity Index is expressed as a ratio and reports the percentage of times two randomly selected people would differ by race ethnicity. An areas Diversity Index would be 1.0 when the population is evenly divided into two or more race ethnic groups. According to ESRI, the 2010 Diversity Index for the United States was 0.60 (55.51 in the Northeast). The CDH service area is becoming increasingly diverse. For the Primary Service Area, the Diversity Index was 0.32 in 2013 expected to increase to 0.35 by 2018 (compound annual growth rate of 1.7 percent). While the Secondary Service Area was less diverse in 2013 (0.15) it is expected to diversify more, with a compound annual growth rate of 2.85, by 2018 than the PSA. Using this measure the most diverse place in the service area is the 01003 neighborhood in Amherst which had a 2013 diversity index of 0.44. A rate greater than 0.6 is considered highly diverse. In 2000, 97 percent of PSA residents and 95 percent of SSA residents were white. Those percentages declined to 82 and 92 percent, respectively, by 2013 and are expected to be 80 and 91 by 2018. It is expected there will be 1486 fewer white residents in the PSA and 64 less in the SSA. The next largest group in the PSA was Asian in 2000 (4.62 percent of the population) and Hispanic in the SSA (1.5 percent). By 2013 the percentage of Asian residents increased to 6 in the PSA and is expected to remain at that level for 2018. By 2013 the Hispanic population in the PSA had grown to 6 percent of the population and is expected to increase to nearly 7 percent of the 2018 population, an increase of 798 individuals. In the SSA in 2000, the Hispanic population (at 1.5 percent of residents) was second to white. By 2013 the Hispanic percentage of the SSA population was 2.74 percent and is expected to grow again to 3.18 percent by 2018. The percentages of Black residents are relatively stable 3.27 percent of the PSA population in 2013 projected to be 3.99 percent in 2018 and 1.27 percent and 1.58 percent in the SSA. The net increase is projected to be 868 persons for the Combined Service Area. Diversity changes in the SSA include Hispanic population growth from 2.29 to 2.79 percent representing 194 individuals. More growth is expected in the Asian SSA population, from 1.92 to 2.24 percent, or 126 persons. Cooley Dickinson spent nearly $503,000 on medical interpreter services during the year to assist non English speaking patients. Recession Impact: Despite that the CDH service area income is relatively high, a snapshot of data from the Massachusetts Division of Insurance shows the economic slowdown has affected the insurance coverage that area residents carry. Insurance enrollment by county as of the quarter ending Sept. 30 for 2012 and 2013 indicates a shift from commercial HMOs and the Commonwealth Connector program to Medicaid. Enrollment in commercial HMOs declined by almost 1 percent in Hampshire and by 1.39 percent in Franklin county 2012 and 2013. Enrollment in the Commonwealth Connector program increased over that period by 2.41 percent in Hampshire and by 0.59 percent in Franklin County. Medicaid continues to see growth, up by 9.61 percent in Hampshire County and 8.89 percent in Franklin. Between 2009 and 2013, HMO enrollment decreased by 2.8 percent in Hampshire County and 8.1 percent in Franklin, with Medicaid increasing 28 percent in Hampshire and 37 percent in Franklin and Connector enrollment increasing 25 percent in both counties. Educational Attainment: Cooley Dickinson serves a population with higher levels of educational attainment than Massachusetts and the nation. Fifty percent of PSA residents have a college degree or higher, compared to 38 percent for Massachusetts and 27 percent U.S. Employment: Educational services and health care are the largest employment sectors in Hampshire and Franklin counties. According to Massachusetts Labor and Workforce Development statistics the top 10 employers in Hampshire and Franklin Counties include six educational facilities and four health care facilities. Service Area Health Status: The Cooley Dickinson Community Health Assessment, published on the hospitals website in fall 2013 provides detailed data about health status in Hampshire and Franklin counties. Residents of the Cooley Dickinson Hospital service areas are generally healthier than the population of Massachusetts and the United States. The County Health Rankings reports show that Hampshire County rates in most areas are either on par with best performing communities or similar to state or national rates. Key findings from the health assessment include the need for improved access to care for some vulnerable populations improved access to a continuum of mental health and addiction services; improve access to care through better coordinated transportation systems; and higher than expected rates of cancer and heart disease for one local community. Access to Care: Cooley Dickinson is one of two not for profit hospitals in Hampshire County. The second, Baystate Mary Lane Hospital, is 50 minutes to 1 hour driving time away from Cooley Dickinson. Baystate Health also has facilities about 30 minutes away in northern Franklin Countys Greenfield and south of the Cooley Dickinson service area in Hampden Countys Springfield. The U.S. Health Resources and Services Administration has designated three communities (Chesterfield, Cummington, and Williamsburg) in Cooley Dickinsons primary service area and four (Ashfield, Huntington, Plainfield, and Worthington) in the secondary service area as Medically Underserved Areas (MUAs). A corporate affiliate, CD Practice Associates, employs two primary care physicians and a nurse practitioner in one of the MUAs, Williamsburg, and the hospital provides rehabilitation services in another, Worthington. In addition, US HRSA has designated four secondary service area communities (Ashfield, Leverett, Shutesbury, and Sunderland) as having Medically Underserved Populations (MUPs). Massachusetts health insurance mandate means the percentage of uninsured residents in the service area is low. Nevertheless, the hospital provides a safety net for the uninsured and underinsured through some use of the emergency department for primary care (approximately 10 percent of visits) and actively seeks to enroll patients and residents in coverage through Hampshire Health Connect. The value of Free Care provided in fiscal 2013 was $4,441,000."},{"form_and_line_reference":"Schedule H, Part VI, Line 5","explanation":"Cooley Dickinson Hospitals mission, \"To provide our patients and communities with the best health care in the most appropriate environment\", is carried out by 259 physicians and more than 1,700 employees. Together they cared for 80,000 community members in the year ending Sept. 30 2013. The medical staff of Cooley Dickinson is organized in the public interest. Medical staff privileges are available to all qualified physicians in the community for all of our departments. In addition, the hospital furthered its exempt purpose through partnerships with our affiliated organization, VNA & Hospice of Cooley Dickinson, and community organizations, ranging from Aging Services Access Points and Councils on Aging to long-term care facilities and boards of health. With these partnerships, we worked toward achieving the best health care through projects such as coordinating care for residents with complex medical and psychosocial issues to improve the quality of life of those residents and prevent their avoidable use of health care services. These partnerships are in addition to those created through the processes of assessing community health needs and developing and implementing our community benefits plan. Funds the hospital generates are reinvested in programs or services that meet the healthcare needs of the community, promote improved health, or prevent illness or injury. For example in 2013, the hospital published four issues of its Community Pulse newsletter which provides health prevention and screening information to encourage residents to maintain or improve their health. The hospital also invested funds, to name a few examples, in recruiting physicians and allied health professionals to meet community need; to upgrade mammography equipment; and to invest in electronic medical records to improve coordination and safety of care. Cooley Dickinson focuses on responsiveness to the healthcare needs of our community. When surveyed in 2012 residents report we succeed at that goal rating us 3.72 on a 4.0 scale on how well we respond to needs. Strong community involvement in our organization is also demonstrated by the fact that 60 percent of the 28 voting members of the Board of Trustees in 2013 were independent (the president and three physician trustees are employees of Cooley Dickinson Health Care; five trustees are employees of Partners HealthCare System; two other trustees are contractors). A total of 91 percent of the 23 community trustees live in the hospitals primary or secondary service area the remaining five trustees were appointed by Massachusetts General Hospital and Partners HealthCare System which acquired Cooley Dickinson in July 2013. In addition, 21 other residents were involved in 2013 as volunteers through the Board of Trustees Healthy Communities and Development and Public Relations Committees. A Patient and Family Advisory Council involved 20 additional residents in decisions regarding their non-profit community hospital."},{"form_and_line_reference":"Schedule H, Part VI, Line 6","explanation":"Cooley Dickinson Hospital, Inc. (the Hospital) is an acute care, not for profit 140 bed community hospital located in Northampton Massachusetts and a wholly owned subsidiary of Cooley Dickinson Health Care Corporation (the Corporation). On July 1, 2013, the Corporation and subsidiaries became affiliates of the Massachusetts General Hospital and Partners HealthCare System, Inc. The Hospital provides a broad range of patient services and a number of health related community services, including acute and critical medicine, surgery, psychiatry, and rehabilitation. The goal of the affiliation is to enhance access for residents of the mid Pioneer Valley service area to a broad range of high quality, affordable health care services; lower the cost of care at the Hospital while improving value; and facilitate the deployment of population health management to improve the health of the residents of the Hospitals service area. The Corporation provides fund raising support and maintains donor-restricted funds for the benefit of the Hospital. Other related entities of the Hospital include CD Practice Associates, Inc. (CDPA), a not for profit organization established to own and manage operating groups of physicians; and VNA and Hospice of Cooley Dickinson, Inc. (VNA), a not for profit organization established to provide home health and hospice care services, as well as Partners HealthCare System, Inc. and its affiliates."},{"form_and_line_reference":"Schedule H, Part VI, Line 7","explanation":"Cooley Dickinson Hospital annually files a Community Benefits report with the Office of the Attorney General of the Commonwealth of Massachusetts."}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":22000,"reported_domestic_individual_grants":0,"reported_domestic_org_grants_program_services":22000,"reported_domestic_individual_grants_program_services":0,"total_501c3_and_government_organizations":2,"total_other_organizations":0,"grants":[{"ein":222477843,"irc_section":"501(c)3","cash":15000,"noncash":0,"purpose":"Funding used by Casa Latina to support information and referral services and to establish a database of referrals.","address_line1":"140 Pine Street No 6","city":"Florence","state":"MA","zip":"01062","name":"Casa Latina Inc","address":"140 Pine Street No 6, Florence, MA, 01062"},{"ein":42562893,"irc_section":"501(c03","cash":7000,"purpose":"Grant to the Strategic Planning Initiative for Families and Youth to conduct the Prevention Needs Assessment Survey (PNAS) in partnership with the school systems of Hampshire County. The PNAS measures youth risky behavior and associated risk and protective factors at the level of individual, family, school, and community domains.","address_line1":"97 Hawley Street","city":"Northampton","state":"MA","zip":"01060","name":"Collaborative for Educational Services Inc SPIFFY","address":"97 Hawley Street, Northampton, MA, 01060"}],"total_domestic_grants":22000,"total_domestic_program_services":22000,"detail_org_grants_total":22000,"detail_domestic_grants_total":22000,"supplemental_information":[{"identifier":"SchI_P01_S00_L02","form_and_line_reference":"Schedule I, Part I, Line 2","explanation":"The grant recipients provided a presentation to the Board of Trustees Subcommittee for Healthy Communities. 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Treasurer/CFO","average_hours_per_week":40.0,"reportable_comp_from_org":267497,"reportable_comp_from_related_orgs":0,"other_compensation":30676,"officer":true},{"title":"Chief Operating Officer","average_hours_per_week":40.0,"reportable_comp_from_org":371706,"reportable_comp_from_related_orgs":0,"other_compensation":18633,"key_employee":true},{"title":"Vice President Medical Affairs/Chief Medical Officer","average_hours_per_week":40.0,"reportable_comp_from_org":303830,"reportable_comp_from_related_orgs":0,"other_compensation":30140,"key_employee":true},{"title":"Chief Information Officer","average_hours_per_week":40.0,"reportable_comp_from_org":197056,"reportable_comp_from_related_orgs":0,"other_compensation":30613,"key_employee":true},{"title":"Vice Pres Patient Care Services","average_hours_per_week":40.0,"reportable_comp_from_org":194177,"reportable_comp_from_related_orgs":0,"other_compensation":4284,"key_employee":true},{"title":"Vice President, Human Resources","average_hours_per_week":40.0,"reportable_comp_from_org":186188,"reportable_comp_from_related_orgs":0,"other_compensation":9793,"key_employee":true},{"title":"Executive Director, CD Practice Associates","average_hours_per_week":40.0,"reportable_comp_from_org":181906,"reportable_comp_from_related_orgs":0,"other_compensation":15265,"key_employee":true},{"title":"Controller","average_hours_per_week":40.0,"reportable_comp_from_org":163306,"reportable_comp_from_related_orgs":0,"other_compensation":19004,"highest_compensated_employee":true},{"title":"Nurse Practitioner/CNS","average_hours_per_week":40.0,"reportable_comp_from_org":156390,"reportable_comp_from_related_orgs":0,"other_compensation":24832,"highest_compensated_employee":true},{"title":"Medical Director","average_hours_per_week":40.0,"reportable_comp_from_org":153362,"reportable_comp_from_related_orgs":0,"other_compensation":13469,"highest_compensated_employee":true},{"title":"Admin Director Emergency Services","average_hours_per_week":40.0,"reportable_comp_from_org":149960,"reportable_comp_from_related_orgs":0,"other_compensation":29909,"highest_compensated_employee":true},{"title":"Admin Director of Compliance, Revenue Cycle, Audit","average_hours_per_week":40.0,"reportable_comp_from_org":146733,"reportable_comp_from_related_orgs":0,"other_compensation":7350,"highest_compensated_employee":true}]},"ScheduleA":{"public_charity_status":{"hospital_170b1_aiii":true}},"ScheduleB":{"attached":true,"required":true},"ScheduleC":{"lobbying_activities":{"volunteers":false,"paid_staff_or_management":false,"media_advertisements":false,"mailings_members":false,"publications_or_broadcast":false,"grants_other_organizations":false,"direct_contact_legislators":true,"direct_contact_legislators_amount":0,"rallies_demonstrations":true,"rallies_demonstrations_amount":28719,"other_activities":false,"total_lobbying_expenditures":28719,"not_described_section_501c3":false},"supplemental_information":[{"identifier":"SchC_P2B_S00_L01","form_and_line_reference":"Schedule C, Part II-B, Line 1","explanation":"Cooley Dickinson Hospital, through membership dues paid to the Massachusetts Hospital Association (MHA) and the American Hospital Association (AHA), supports the lobbying activities carried out by these organizations. MHA and AHA have reported to Cooley Dickinson Hospital the portion of the dues that are used for lobbying purposes on behalf of member hospitals."}]},"ScheduleD":{"endowment_funds":{"current_year":{"beginning_year_balance":3879597,"contributions":0,"investment_earnings_or_losses":582197,"grants_or_scholarships":1131,"other_expenditures":78039,"administrative_expenses":0,"end_year_balance":4382624},"current_year_minus1":{"beginning_year_balance":3953056,"contributions":100,"investment_earnings_or_losses":8786,"grants_or_scholarships":1395,"other_expenditures":80950,"administrative_expenses":0,"end_year_balance":3879597},"current_year_minus2":{"beginning_year_balance":3892904,"contributions":150,"investment_earnings_or_losses":125417,"grants_or_scholarships":1500,"other_expenditures":63915,"administrative_expenses":0,"end_year_balance":3953056},"current_year_minus3":{"beginning_year_balance":3913781,"contributions":10720,"investment_earnings_or_losses":30998,"grants_or_scholarships":1100,"other_expenditures":61495,"administrative_expenses":0,"end_year_balance":3892904},"board_designated_eoy_percentage":0.44,"permanent_endowment_eoy_percentage":0.12,"term_endowment_eoy_percentage":0.44,"held_by_unrelated_organizations":false,"held_by_related_organizations":true,"related_organizations_listed_schedule_r":true},"land_buildings_equipment":{"land":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":1783897,"book_value":1783897},"buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":63332957,"book_value":42149419,"depreciation":21183538},"leasehold_improvements":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":45759016,"book_value":15145860,"depreciation":30613156},"equipment":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":83472241,"book_value":10310466,"depreciation":73161775},"other_land_buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":3274639,"book_value":1712114,"depreciation":1562525},"total_book_value":71101756},"other_assets":{"assets":[{"description":"beneficial interest held by affiliate","book_value":8298717},{"description":"medical malpractice rec'b","book_value":7148238},{"description":"other receivables","book_value":836900},{"description":"due from 3rd parties","book_value":341572},{"description":"other assets","book_value":346639}],"total_book_value":16972066},"other_liabilities":{"federal_income_tax_liability":0,"liabilities":[{"description":"pension liability","amount":42524977},{"description":"estimated settlements due to 3rd parties","amount":10893735},{"description":"medical malpractice payable","amount":7148238},{"description":"other liabilities","amount":3689377}],"total_liability":64256327},"net_assets_reconciliation":{"total_revenue":167877612,"total_expenses":149569052,"excess_or_deficit_for_year":18308560,"net_unrealized_gains_losses_on_investments":-102628,"donated_services_and_facilities":0,"investment_expenses":0,"prior_period_adjustments":0,"other_amount":-5267606,"total_adjustments":-5370234,"excess_or_deficit_per_financial_statements":12938326},"revenue_reconciliation":{"total_revenue_audited_financial_statements":166299932,"net_unrealized_gains_investments":0,"donated_services_and_use_facilities":0,"recoveries_prior_year_grants":0,"other_revenue":0,"revenue_not_reported":0,"revenue_subtotal":166299932,"investment_expenses_not_included":0,"other_revenues_not_included":1577680,"revenue_not_reported_financial_statement":1577680,"total_revenue_per_990":167877612},"expense_reconciliation":{"total_expenses_audited_financial_statements":149569052,"donated_services_use_facilities":0,"prior_year_adjustments":0,"losses_reported":0,"other_expenses_included":0,"expenses_not_reported":0,"expenses_subtotal":149569052,"investment_expenses_not_included":0,"other_expenses_not_included":0,"expenses_not_reported_financial_statement":0,"total_expenses_per_990":149569052},"supplemental_information":[{"identifier":"SchD_P05_S00_L04","form_and_line_reference":"Schedule D, Part V, Line 4","explanation":"The income from endowed funds is expendable to support healthcare services and nursing scholarships in furtherance of the organization's exempt mission."},{"identifier":"SchD_P10_S00_L01","form_and_line_reference":"Schedule D, Part X, Line 1","explanation":"Liabilities not detailed in Form 990 Part X lines 17 through 24; pension liability, estimated settlements to 3rd parties, etc."},{"identifier":"SchD_P11_S00_L08","form_and_line_reference":"Schedule D, Part XI, Line 8","explanation":"Minimum pension liability adjustment, (3,787,865); Transfers to CD Practice Associates for start up operations, (3,085,328); Transfers from Cooley Dickinson Health Care Corporation to finance property and equipment, 120,259; Change in beneficial interest, temp restricted, 1,485,328."},{"identifier":"SchD_P12_S00_L04b","form_and_line_reference":"Schedule D, Part XII, Line 4b","explanation":"Non-operating gains, 1,577,680."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":false,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":1460653,"bad_debt_expense_attributable_to_financial_assistance":497981,"reimbursed_by_medicare":41950633,"cost_of_care_reimbursed_by_medicare":43433800,"medicare_surplus_or_shortfall":-1483167,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":2818427,"direct_offsetting_revenue":536170,"net_community_benefit_expense":2282257,"total_expense_percentage":0.0156},"unreimbursed_medicaid":{"total_community_benefit_expense":14995298,"direct_offsetting_revenue":12522982,"net_community_benefit_expense":2472316,"total_expense_percentage":0.0169},"unreimbursed_costs":{"total_community_benefit_expense":3685243,"direct_offsetting_revenue":3127339,"net_community_benefit_expense":557904,"total_expense_percentage":0.0038},"total_financial_assistance":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":21498968,"direct_offsetting_revenue":16186491,"net_community_benefit_expense":5312477,"total_expense_percentage":0.0363},"community_health_services":{"total_community_benefit_expense":1899423,"direct_offsetting_revenue":362923,"net_community_benefit_expense":1536500,"total_expense_percentage":0.0105},"subsidized_health_services":{"total_community_benefit_expense":4330521,"direct_offsetting_revenue":3580658,"net_community_benefit_expense":749863,"total_expense_percentage":0.0051},"total_other_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":6229944,"direct_offsetting_revenue":3943581,"net_community_benefit_expense":2286363,"total_expense_percentage":0.0156},"total_community_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":27728912,"direct_offsetting_revenue":20130072,"net_community_benefit_expense":7598840,"total_expense_percentage":0.0519}},"community_building":{"health_improvement_advocacy":{"total_community_benefit_expense":4645,"direct_offsetting_revenue":0,"net_community_benefit_expense":4645,"total_expense_percentage":0.0},"total_community_building_activities":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":4645,"direct_offsetting_revenue":0,"net_community_benefit_expense":4645,"total_expense_percentage":0.0}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"Cooley Dickinson Hospital Inc","address_line1":"30 Locust Street","city":"Northampton","state":"MA","zip":"01060","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"Cooley Dickinson Hospital Inc","address":"30 Locust Street, Northampton, MA, 01060"}],"facility_policies":[{"business_name_line1":"Cooley Dickinson Hospital Inc","facility_number":1,"eligibility_criteria_explained":true,"fpg_family_income_limit_free_discounted":true,"fpg_family_income_limit_free_care_percentage":200.0,"fpg_used_determine_discounted_care":false,"basis_explained":false,"application_financial_assistance_explanation":true,"other_method_used":true,"includes_publicity_measures":true,"fap_available_on_website":true,"fap_available_on_request_no_charge":true,"fap_actions_on_nonpayment":true,"attached_to_invoice":true,"posted_in_admission_office":true,"posted_in_emergency_room":true,"provided_on_admission":true,"collection_activities":false,"nondiscriminatory_emergency_care_policy":true,"amounts_generally_billed":false,"gross_charges":false,"name":"Cooley Dickinson Hospital Inc"}],"supplemental_information":[{"form_and_line_reference":"Schedule H, Part I, Line 3c","explanation":"Service recovery activities occasionally include discounted care."},{"form_and_line_reference":"Schedule H, Part I, Line 7","explanation":"The costing methodology used was the ratio of patient service expense to patient service revenue from the FY2012 Massachusetts Division of Health Care Finance and Policy 403 cost report of Cooley Dickinson Hospital."},{"form_and_line_reference":"Schedule H, Part I, Line 7, Column f","explanation":"Bad debt expense totaling $3,591,651 is included in Form 990, Part IX, line 25, column A, but pursuant to IRS instruction, has been excluded from the expense figure for the purpose of calculating the percentage of total expenses in Schedule H, Part I, line 7, column (f)."},{"form_and_line_reference":"Schedule H, Part II","explanation":"Cooley Dickinson's vision is to make the community it serves the nation's model healthy community. One step toward making that vision real is to include consumer-friendly preventive, screening, or general health information in every issue of the Community Pulse newsletter that the hospital publishes. Some of the health information is linked to the community's health status. For example, the incidence of chronic disease, such as cancer, is on par with - or slightly more prevalent than, which varies by town - cancer prevalence in Massachusetts. In 2012, the Community Pulse included information about cancer warning signs, (Reducing Breast Cancer Risk: What Can One Woman Do), offered genetic counseling and testing appointments through Cooley Dickinson's collaboration with Massachusetts General Hospital Cancer Center, and partnered with the American Cancer Society to offer support groups such as Look Good, Feel Better, a program for women going through chemotherapy and/or radiation therapy. Preventive health is also covered in the Community Pulse. In 2012, readers had access to an online video on how to prepare a healthy summertime recipe and were given local farmers' markets schedules. At the start of the school year, parents received tips on how to prepare healthy lunches for their kids and diabetics received information about complications and a program to support them. In addition, Community Pulse readers were offered an opportunity to redeem a free book, The Patient's Checklist: 10 Simple Hospital Checklists to Keep You Safe, Sane, and Organized, via Cooley Dickinson's call center. Nearly 75 people took advantage of this offer."},{"form_and_line_reference":"Schedule H, Part III, Section A, Line 4","explanation":"The audited financial statements for Cooley Dickinson Hospital do not contain a footnote describing bad debt expense. The costing methodology was the ratio of patient service expense to patient service revenue from the FY2012 Massachusetts Division of Health Care Finance and Policy 403 cost report of Cooley Dickinson Hospital."},{"form_and_line_reference":"Schedule H, Part III, Section B, Line 8","explanation":"The full unsubsidized cost of providing care to Medicare patients should be included as a community benefit. The source for line 6 is the Cooley Dickinson Hospital FY2012 Medicare Cost Report."},{"form_and_line_reference":"Schedule H, Part III, Section C, Line 9b","explanation":"The Hospital will not bill patients enrolled in MassHealth, patients receiving governmental benefits under the Emergency Aid to the Elderly, Disabled and Children program, or participants in the Healthy Start program except that the Hospital may bill patients for any co-pays and deductibles required under the program of assistance. The Hospital may initiate billing for a patient who alleges that he or she is a participant in any of these programs but fails to provide proof of such participation (including receipt or verification of signed application). Upon receipt of satisfactory proof that a patient is enrolled in any of the above listed programs, or receipt of the signed application, the Hospital shall cease its collection activities. Participants in the Children's Medical Security Plan (CMSP) whose Family Income is equal to or less than 400% of the Federal Poverty Level (FPL) are also exempt from Collection Action. The Hospital may initiate billing for a patient who alleges that he or she is a participant in the CMSP, but fails to provide proof of such participation. Upon receipt of satisfactory proof that a patient is a participant in the CMSP, the Hospital shall cease all collection activities. Low Income Patients are exempt from Collection Action for any Eligible services received during the period in which they are determined to be Low Income Patients and eligible for payment by the Health Safety Net, except for co-pays and deductibles. Low Income Patients with Family Income between 201 to 400% of the FPL are exempt from Collection Action for the portion of his or her Hospital bill that exceeds the deductible except for Health Safety Net co-payments and deductibles as set forth in 114.6 CMR 13.04. The Hospital may bill for services received outside of the period in which they are determined to be Low Income Patients. The Hospital may bill Low Income Patients for services rendered prior to the Low Income Patient determination, provided that the current Low Income Patient status has been terminated, expired, or not otherwise identified on the state Virtual Gateway or Eligibility Verification System. The Hospital 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. The Hospital may not undertake a Collection Action against an individual that has qualified for Medical Hardship under the Massachusetts Health Safety Net program with respect to the amount of the bill that exceeds the Medical Hardship contribution. The Hospital will further cease any collection efforts against an emergency bad debt claim that is approved for Medical Hardship under the Health Safety Net program. The Hospital 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, provided that the state of Massachusetts will file its own recovery action for those patients enrolled in MassHealth or the Health Safety Net. The Hospital complies with all applicable billing requirements including those in the Department of Public Health regulations (105 CMR 130.332) for non payment of services or readmissions that the Hospital determines to be a result of a Serious Reportable Event (SRE). SREs that do not occur at the Hospital are excluded from this determination of non-payment. Additionally, the Hospital does not bill low income patients eligible for the Health Safety Net when claims are denied by an insurance company as a result of an administrative billing error by the Hospital."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 10","explanation":"The Hospital does not have a discounted care policy."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 19","explanation":"The Hospital charges all patients uniformly regardless of insurance coverage. For patients that are FAP eligible, the only bill they will receive from the Hospital is the amount due as determined by the insurance program that they qualify for through the state."},{"form_and_line_reference":"Schedule H, Part VI, Line 2","explanation":"Cooley Dickinson Hospital conducted a comprehensive needs assessment and published the results in January, 2011. The format for the assessment includes a detailed secondary data report. The report includes a detailed description of the demographics in our service area including population characteristics such as age, race, education, income, and language - all indicators that are among the social determinants of health. The report includes detailed data on birth and death including leading causes of death, mortality, life expectancy at birth, infant mortality, low birth weight, and teen birth rate. The chronic disease section includes data on cancer (all, breast, prostate, lung, and colon); asthma, (adult and child), cholesterol screening, diabetes, heart disease, high blood pressure, stroke, and perceptions of health). The substance abuse sections includes data on 30 day past use of alcohol, marijuana, and other drugs among 10th and 12th graders at local schools, youth binge drinking, and tobacco use. The food and fitness section includes data on the food environment, such as number of farmer's markets, recreation and fitness facilities, and percent of low income households that are more than 1 mile from a grocery store. It also includes health behaviors including consumption of fruits and vegetables, engagement in physical activity, and adult and child overweight/obesity. The health care access section includes an assessment of Latino health access and barriers to health care for recent immigrants, veterans, people with behavioral and social concerns that impact access. The health assessment also featured a community survey for one community that was conducted door to door and at community events. The results were also published in January, 2011. Both reports were presented in detail at a community forum in March, 2011 that was attended by approximately 150 people. The forum was promoted widely in the area and received media coverage including information on where to find the report (the hospital's website). The health assessment also featured the results of a community Photovoice project, where participating residents were offered the opportunity to describe their community's strengths and challenges using photography. The results were showcase at the March event. The health assessment results were discussed in this community forum and the community was offered the opportunity to make recommendations for strategies and programming. The Cooley Dickinson Hospital Board of Trustees Healthy Communities Committee made the final decisions about priorities and funding. This committee is made up of community residents, board members, and hospital staff. The final plan and budget are approved by the full Board of Trustees annually."},{"form_and_line_reference":"Schedule H, Part VI, Line 3","explanation":"Cooley Dickinson Hospital posts signs in the inpatient, clinic, and emergency admissions/registration areas and in business office areas that are customarily used by patients that conspicuously inform patients of the availability of financial assistance programs and the Hospital location at which to apply for such programs. All signs and notices are translated into English and Spanish. The signs notify patients of the availability of financial assistance and of other programs of public assistance. Hampshire HealthConnect (HHC), a Cooley Dickinson Hospital based program, has a mission to help uninsured and underinsured people access health coverage and care. HHC case managers assist uninsured patients to enroll with MassHealth, Health Safety Net and other state healthcare programs. HHC also administers the Hampshire Health Physician Network, a group of local physicians who offer health care to local residents who are low income and cannot qualify for MassHealth or other health insurance. Participating physicians agree to accept reduced fees and are not reimbursed by the Health Safety Net for their services. HHC flyers are distributed to all self pay patients in the emergency department and throughout the Hospital. The Hospital provides an individual notice of the availability of financial assistance programs, including Medical Hardship, to patients expected to incur charges. The Hospital will include a notice about eligible services to Low Income Patients and programs of public assistance in its initial bill and in all written collection actions stating: \"If you are unable to pay this Hospital bill, you may be eligible for coverage through a financial assistance program. Enrollment in many programs is time-sensitive, so please contact our Hampshire HealthConnect Department as soon as possible. To speak with someone in the Hampshire HealthConnect Department, please call (413) 582-2848, Monday through Friday 9:00 am to 5:00 pm. You may also obtain information at the Cashier's Office located in the main entrance of the Hospital.\""},{"form_and_line_reference":"Schedule H, Part VI, Line 4","explanation":"Cooley Dickinson Hospital (CDH) serves a population (2010) of 136,383 residents of Hampshire and Franklin counties in the Pioneer Valley region of Massachusetts. Its primary service area (PSA) is comprised of fifteen Hampshire and one Franklin community and secondary service area (SSA) of five Hampshire and six Franklin communities. The PSA includes the following communities from which 50 percent or more of inpatient hospital admissions were to CDH for the three years from fiscal 2008 through fiscal 2010. Amherst, Chesterfield, Cummington, Easthampton, Florence, Goshen, Hadley, Hatfield, Haydenville, Leeds, North Amherst, North Hatfield, Northampton, West Hatfield, Whately, Williamsburg. The following communities, from which 25 percent of more of inpatient hospital admissions were to CDH for the three-year period, comprise the SSA. Belchertown does not meet the 25 percent share threshold, but is included because it has the seventh highest volume of discharges. Ashfield, Belchertown, Huntington, Leverett, Plainfield, Shutesbury, South Deerfield, Southampton, Sunderland, West Chesterfield, and Worthington. Population Trends Overall; The PSA population is expected to decline by 0.37 percent by 2015 after growing by 1.7 percent from 2000 to 2010. Growth of 0.70 percent is expected for the SSA, according to population data from ESRI Business Information Solutions. This projected stability follows a period of growth, by 4.67 percent, of the SSA population between 2000 and 2010. Factors of interest in planning hospital services and projecting use of hospital services are highlighted below. Aging; The service area is graying, consistent with national trends. * 11.79 percent of the PSA population and 11.71 percent of the SSA was 65 or older in 2010. These rates are lower than for Massachusetts (13.8 percent) and the United States (13 percent). (By 2015, 13.84 percent of the PSA population and 14.62 percent of the SSA is expected to be 65+; for Massachusetts the percentage will be 15.3 and US, 14.43). * The age cohorts starting at traditional retirement age (65) are growing the fastest. The compound annual growth rate for area residents 65-79 is 5.51 percent in the primary service area and 6.38 percent in the secondary service area. (This means that by 2015, there will be 2,328 more 65-79 year-olds in the PSA and 1,177 more in the SSA). * By contrast, the number of residents in the primary and secondary service areas at the upper end of the age spectrum is expected to decline by 2015. The population age 80+ will have a negative compound annual growth rate, amounting to 400 fewer adults 80 or older (351 in the PSA alone) by 2015. * Children and Young Adults. The population up to age 14 and that 15-24 will both decline by 2015, amounting to 215 fewer children (133 from PSA; 82 from SSA) and 1,469 fewer young adults (1,212 from PSA and 257 from SSA). The decline in the population under 24 is not surprising given lower birth rates in our service area. Rates are reported by the Massachusetts Department of Public Health for the state and state-defined community health network areas in our region and compared to the US rate reported by the National Center for Health Statistics. The Franklin rate of 9.2 is higher than it was in 2008 (8.8 births per 1000 residents), while the Hampshire rate of 7.1 - the lowest among Massachusetts community health networks in 2009 - declined from 8.0 in 2008. The Massachusetts rate of 11.4 was down slightly from 11.8 in 2008. Demographic Profile of Service Area; Income; The communities Cooley Dickinson serves have higher median household incomes than Hampshire and Franklin counties, Massachusetts, and the nation, according to ESRI and US Census data. The US rate is $50,046; Franklin County, $52,002; Hampshire County, $58,449; Cooley Dickinson Primary Service Area, $61,625; Massachusetts, $62,072; CDH Combined Service Area, $64,187; and CDH Secondary Service Area, $70,392. The range of median household incomes in the PSA in 2010 was from $43,148 in North Amherst to $82,139 in the 01063 zip code in Northampton, the Smith College neighborhood. For the SSA, the range is from $48,002 in Sunderland to $89,849 in Southampton. The US census has not yet released 2010 information about residents living below the poverty level for all communities in the service area. Two of the four areas for which data is available report rates well above the 2010 Massachusetts percentage of 10.5 percent of residents living below poverty level and US rate, 13.8 percent. They are Amherst Center (30.8 percent) and North Amherst (43 percent). The rate for Northampton is 13.1 percent and for Easthampton, 6.2 percent. The toll of the recession is evident here: the 2000 Census reported the percentages of people living below the poverty level as 6.7 in Massachusetts and 9.2 in the nation. Race and Ethnicity; The Census Bureau has developed a Diversity Index to compute the differences in diversity among populations. The Diversity Index is expressed as a ratio and reports the percentage of times two randomly selected people would differ by race/ethnicity. An area's Diversity Index would be 1.0 when the population is evenly divided into two or more race/ethnic groups. According to ESRI, the 2010 Diversity Index for the United States was 0.60 (55.51 in the Northeast). The CDH service area is becoming increasingly diverse. For the Primary Service Area, the Diversity Index is 0.30, expected to increase to 0.33 by 2015, with a compound annual growth rate of 1.87 percent. While the Secondary Service Area was less diverse in 2010 (0.13), it is expected to diversify more, with a compound annual growth rate of 3.14, by 2015 than the PSA. In 2000, 97 percent of PSA residents and 95 percent of SSA residents were white. Those percentages declined to 83 and 93 percent, respectively, by 2010 and are expected to be 81 and 92 by 2015. It is expected there will be 2,208 fewer white residents in the PSA and 218 less in the SSA. The next largest group in the PSA was Asian in 2000 (4.62 percent of the population) and Hispanic in the SSA (1.5 percent); in both service areas, Hispanic was second in 2010. By 2015, the Hispanic population in the PSA is expected to increase from 6.2 percent of the 2010 population to 7.25 percent, representing an increase of 1,017 individuals. The percentages of the Black and Asian populations are expected to grow by less than 1 percent by 2015, with net increases of 288 and 275 persons. Diversity changes in the SSA include Hispanic population growth from 2.29 to 2.79 percent, representing 194 individuals. More growth is expected in the Asian SSA population, from 1.92 to 2.24 percent, or 126 persons. Cooley Dickinson spent more than $483,000 on medical interpreter services during the year to assist non-English speaking patients. Educational Attainment; Cooley Dickinson serves a population with higher levels of educational attainment than Massachusetts and the nation. Fifty percent of PSA residents have a college degree or higher, compared to 38 percent for Massachusetts and 27 percent U.S. Employment; Not surprisingly given the educational attainment of residents of the service area, the occupational makeup of the population differs from that of the nation."},{"form_and_line_reference":"Schedule H, Part VI, Line 4 Cont","explanation":"Educational services and health care are the largest employment sectors in Hampshire and Franklin counties. In the United States, 23.24 percent of the population is employed in education, health care, and social assistance. That rate is higher (28.69 percent) in Hampshire County and lower (21.53 percent) in Franklin. Both Hampshire and Franklin Counties have lower percentages than the nation of people employed in the second largest sector, retail trade (US 11.65 percent; Hampshire 8.88 percent; and Franklin 8.47 percent). (US Census; counties, Economic Development Data & Information for Connecticut and Western Massachusetts [EDDI]). The top 10 employers in Hampshire and Franklin Counties include three health facilities, including Cooley Dickinson, and nine educational facilities, including five colleges, two private secondary schools, and two public school districts. Service Area Health Status; The Cooley Dickinson Community Health Assessment, published March 2011, provides detailed data about health status in Hampshire and Franklin Counties. Residents of the Cooley Dickinson Hospital service areas are generally healthier than the population of Massachusetts and the United States. The federal Community Health Status Reports for 2009 for Hampshire and Franklin Counties indicate better average life expectancy, fewer deaths per 100,000 residents, and lower rates of self-reported fair or poor health than the United States. In both counties, the rate of reported unhealthy days in the previous month was slightly higher than the U.S. median. The reports also compare both counties on 19 indicators of health to both the United States and a group of peer counties. Hampshire County's results are better than both the U.S. and peer counties on 16 of the indicators. Franklin County's results are better than both for 10 indicators. The two counties share unfavorable data compared to peers and the United States on three indicators: births to women age 40-54, breast cancer, and colon cancer. Franklin also has unfavorable rates of very low birth weight babies. As described in the hospital's Community Needs Assessment, a deeper look at the health status data reveals increasing obesity rates, increasing diabetes rates, and disparities in asthma prevalence (based on location). Access to Care; Cooley Dickinson is one of two not-for-profit hospitals in Hampshire County. The second, Baystate Mary Lane Hospital, is 50 minutes to 1 hour driving time away from Cooley Dickinson. Baystate Health also has facilities about 30 minutes away in northern Franklin County's Greenfield and south of the Cooley Dickinson service area in Hampden County's Springfield. The U.S. Health Resources and Services Administration has designated three communities (Chesterfield, Cummington, and Williamsburg) in Cooley Dickinson's primary service area and four (Ashfield, Huntington, Plainfield, and Worthington) in the secondary service area as Medically Underserved Areas (MUAs). A corporate affiliate, Cooley Dickinson Practice Associates, employs two primary care physicians and a nurse practitioner in one of the MUAs, Williamsburg, and the hospital provides rehabilitation services in another, Worthington. In addition, US HRSA has designated one primary service area community (Whately) and three secondary service area communities (Leverett, Shutesbury, and Sunderland) as having Medically Underserved Populations (MUPs). While Cooley Dickinson Practice Associates does not have providers located in Sunderland, its primary care providers have 1,261 of Sunderland's 3,781 residents as patients. Massachusetts' health insurance mandate means the percentage of uninsured residents in the service area is low. Nevertheless, the hospital provides a safety net for the uninsured and underinsured through some use of the emergency department for primary care - approximately 10 percent of visits - and actively seeks to enroll patients and residents in coverage through Hampshire Health Connect. The value of Free Care provided in fiscal 2012 was $4,633,000."},{"form_and_line_reference":"Schedule H, Part VI, Line 5","explanation":"Cooley Dickinson Hospital's mission, \"To provide our patients and communities with the best health care in the most appropriate environment,\" is carried out by 317 physicians and more than 1,700 employees, including 415 nurses, and 398 volunteers. Together, they cared for 80,600 community members in the year ending Sept. 30, 2012. The medical staff of Cooley Dickinson is organized in the public interest. Medical staff privileges are available to all qualified physicians in the community for all of our departments. In addition, the hospital furthered its exempt purpose through partnerships with our affiliated organization, VNA & Hospice of Cooley Dickinson, and community organizations, ranging from Aging Services Access Points and Councils on Aging to long-term care facilities and boards of health. With these partnerships, we worked toward achieving the best health care through projects such as coordinating care for residents with complex medical and psychosocial issues to improve the quality of life of those residents and prevent their avoidable use of health care services. These partnerships are in addition to those created through the processes of assessing community health needs and developing and implementing our community benefits plan. Funds the hospital generates are reinvested in programs or services that meet the healthcare needs of the community, promote improved health, or prevent illness or injury. For example, in 2012, the hospital published eight issues of its Community Pulse newsletter, which provides health prevention and screening information to encourage residents to maintain or improve their health. The hospital also invested surplus funds - to name a few examples - in recruiting physicians and allied health professionals to meet community need; to upgrade equipment for patients requiring cardiac and pulmonary rehabilitation; and to invest in electronic medical records to improve coordination and safety of care. Cooley Dickinson focuses on responsiveness to the health care needs of our community. When surveyed in 2012, residents report we succeed at that goal, rating us 3.67 on a 4.0 scale on how well we respond to needs. This research will be repeated in Fiscal 2013 to ensure community members still find the hospital responsive. Strong community involvement in our organization is also demonstrated by the fact that 75 percent of the 24 voting members of the Board of Trustees are independent (the president and three physician trustees are employees of the organization; two other trustees are contractors). A total of 96 percent of the current of trustees live in the hospital's primary or secondary service area. In addition, 32 other residents are involved as volunteers through the Board of Trustees' Healthy Communities and Development and Public Relations Committees. A Patient and Family Advisory Council involves 20 additional residents in decisions regarding their non-profit community hospital."},{"form_and_line_reference":"Schedule H, Part VI, Line 6","explanation":"Cooley Dickinson Hospital, Inc. (the \"Hospital\") is an acute care, not-for-profit 140 bed community hospital located in Northampton Massachusetts and a wholly owned subsidiary of Cooley Dickinson Health Care Corporation (the \"Corporation\"). The Hospital provides a broad range of patient services and a number of health related community services, including acute and critical medicine, surgery, psychiatry, and rehabilitation. The Corporation provides fund raising support and maintains donor-restricted funds for the benefit of the Hospital. Other related entities of the Hospital include CD Practice Associates, Inc. (\"CDPA\"), a not-for-profit organization established to own and manage operating groups of physicians; and VNA and Hospice of Cooley Dickinson, Inc. (\"VNA/Hospice\"), a not-for-profit organization established to provide home health and hospice care services."},{"form_and_line_reference":"Schedule H, Part VI, Line 7","explanation":"Cooley Dickinson Hospital annually files a Community Benefits report with the Office of the Attorney General of the Commonwealth of Massachusetts."}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":41500,"reported_domestic_individual_grants":0,"reported_domestic_org_grants_program_services":41500,"reported_domestic_individual_grants_program_services":0,"total_501c3_and_government_organizations":4,"total_other_organizations":0,"grants":[{"ein":43313646,"irc_section":"501(c)3","cash":11400,"noncash":0,"purpose":"Funding was used to provide professional training for Jackson St. School teachers to become proficient in leading lessons in and from the school garden. They worked with School Sprouts Educational Gardens in the design and creation of the garden curriculum. In addition, two School Food Forums were held, at Jackson St. and Williamsburg Schools, providing direct, hands-on professional development workshops for educators and parents.","address_line1":"593 South Pleasant Street","city":"Amherst","state":"MA","zip":"01002","name":"Open Field Foundation Inc","address":"593 South Pleasant Street, Amherst, MA, 01002"},{"ein":222477843,"irc_section":"501(c)3","cash":7500,"noncash":0,"purpose":"Funding used by Casa Latina to support information and referral services and to establish a database of referrals.","address_line1":"140 Pine Street No 6","city":"Florence","state":"MA","zip":"01062","name":"Casa Latina Inc","address":"140 Pine Street No 6, Florence, MA, 01062"},{"ein":42562893,"irc_section":"501(c)3","cash":7500,"noncash":0,"purpose":"Funding was used to create a Hampshire County Food and Fitness Policy Council which focused on increasing access to healthy eating and physical activity for children, families and adults, and in particular for underserved populations such as low income residents and recent immigrants in Hampshire County.","address_line1":"97 Hawley Street","city":"Northampton","state":"MA","zip":"01060","name":"Collaborative for Educational Services Inc SPIFFY","address":"97 Hawley Street, Northampton, MA, 01060"},{"ein":46001424,"cash":7500,"noncash":0,"purpose":"Funding used to bring together a wide range of community partners to effectively prepare for a community-wide strategic planning and implementation process for nutrition and physical activity, under the structure of the Communities that Care Coalition in Franklin County.","address_line1":"425 Main Street Suite 20","city":"Greenfield","state":"MA","zip":"01301","name":"Community Coalition for Teens A Program of the Franklin Regional Council of Governments","address":"425 Main Street Suite 20, Greenfield, MA, 01301"}],"total_domestic_grants":41500,"total_domestic_program_services":41500,"detail_org_grants_total":33900,"detail_domestic_grants_total":33900,"supplemental_information":[{"identifier":"SchI_P01_S00_L02","form_and_line_reference":"Schedule I, Part I, Line 2","explanation":"The grant recipients provided a presentation to the Board of Trustees Subcommittee for Healthy Communities. Recipients are also expected to submit a written annual report to the Committee."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"The grant recipients provided a presentation to the Board of Trustees Subcommittee for Healthy Communities. Recipients are also expected to submit a written annual report to the Committee.","form_and_line_reference":"Schedule I, Part I, Line 2"}},"ScheduleF":{"reported_foreign_grants":0,"reported_foreign_grants_program_services":0},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"independent_consultant":true,"compensation_survey_or_study":true,"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":true,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"Craig N 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Treasurer/CFO","average_hours_per_week":40.0,"reportable_comp_from_org":257274,"reportable_comp_from_related_orgs":0,"other_compensation":33698,"officer":true},{"title":"Chief Operating Officer","average_hours_per_week":40.0,"reportable_comp_from_org":372018,"reportable_comp_from_related_orgs":0,"other_compensation":18039,"key_employee":true},{"title":"Chief Information Officer","average_hours_per_week":40.0,"reportable_comp_from_org":227915,"reportable_comp_from_related_orgs":0,"other_compensation":30321,"key_employee":true},{"title":"Vice Pres, Clinical & Professional Services","average_hours_per_week":40.0,"reportable_comp_from_org":189758,"reportable_comp_from_related_orgs":0,"other_compensation":16660,"key_employee":true},{"title":"Vice Pres Patient Care Services","average_hours_per_week":40.0,"reportable_comp_from_org":176009,"reportable_comp_from_related_orgs":0,"other_compensation":8109,"key_employee":true},{"title":"Vice President, Human Resources","average_hours_per_week":40.0,"reportable_comp_from_org":173588,"reportable_comp_from_related_orgs":0,"other_compensation":10756,"key_employee":true},{"title":"Executive Director, CD Practice Associates","average_hours_per_week":40.0,"reportable_comp_from_org":157980,"reportable_comp_from_related_orgs":0,"other_compensation":21703,"key_employee":true},{"title":"Psychiatrist","average_hours_per_week":40.0,"reportable_comp_from_org":272046,"reportable_comp_from_related_orgs":0,"other_compensation":26240,"highest_compensated_employee":true},{"title":"Medical Physicist","average_hours_per_week":40.0,"reportable_comp_from_org":240361,"reportable_comp_from_related_orgs":0,"other_compensation":23024,"highest_compensated_employee":true},{"title":"Psychiatrist","average_hours_per_week":40.0,"reportable_comp_from_org":204087,"reportable_comp_from_related_orgs":0,"other_compensation":13556,"highest_compensated_employee":true},{"title":"Vice President Medical Affairs/Chief Medical Officer","average_hours_per_week":40.0,"reportable_comp_from_org":176092,"reportable_comp_from_related_orgs":0,"other_compensation":22483,"highest_compensated_employee":true},{"title":"Admin Director Emergency Services","average_hours_per_week":40.0,"reportable_comp_from_org":156415,"reportable_comp_from_related_orgs":0,"other_compensation":27809,"highest_compensated_employee":true}]},"ScheduleA":{"public_charity_status":{"hospital_170b1_aiii":true}},"ScheduleB":{"attached":true,"required":true},"ScheduleC":{"lobbying_activities":{"volunteers":false,"paid_staff_or_management":false,"media_advertisements":false,"mailings_members":false,"publications_or_broadcast":false,"grants_other_organizations":false,"direct_contact_legislators":true,"direct_contact_legislators_amount":0,"rallies_demonstrations":true,"rallies_demonstrations_amount":29772,"other_activities":false,"total_lobbying_expenditures":29772,"not_described_section_501c3":false},"supplemental_information":[{"identifier":"SchC_P2B_S00_L01","form_and_line_reference":"Schedule C, Part II-B, Line 1","explanation":"Cooley Dickinson Hospital, through membership dues paid to the Massachusetts Hospital Association (MHA) and the American Hospital Association (AHA), supports the lobbying activities carried out by these organizations. MHA and AHA have reported to Cooley Dickinson Hospital the portion of the dues that are used for lobbying purposes on behalf of member hospitals."}]},"ScheduleD":{"endowment_funds":{"current_year":{"beginning_year_balance":3953056,"contributions":100,"investment_earnings_or_losses":8786,"grants_or_scholarships":1395,"other_expenditures":80950,"administrative_expenses":0,"end_year_balance":3879597},"current_year_minus1":{"beginning_year_balance":3892904,"contributions":150,"investment_earnings_or_losses":125417,"grants_or_scholarships":1500,"other_expenditures":63915,"administrative_expenses":0,"end_year_balance":3953056},"current_year_minus2":{"beginning_year_balance":3913781,"contributions":10720,"investment_earnings_or_losses":30998,"grants_or_scholarships":1100,"other_expenditures":61495,"administrative_expenses":0,"end_year_balance":3892904},"board_designated_eoy_percentage":0.5,"permanent_endowment_eoy_percentage":0.13,"term_endowment_eoy_percentage":0.37,"held_by_unrelated_organizations":false,"held_by_related_organizations":true,"related_organizations_listed_schedule_r":true},"land_buildings_equipment":{"land":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":1783897,"book_value":1783897},"buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":63409955,"book_value":44408009,"depreciation":19001946},"leasehold_improvements":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":44567246,"book_value":17446561,"depreciation":27120685},"equipment":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":78898793,"book_value":10653368,"depreciation":68245425},"other_land_buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":3269394,"book_value":1798513,"depreciation":1470881},"total_book_value":76090348},"other_liabilities":{"federal_income_tax_liability":0,"liabilities":[{"description":"pension liability","amount":38605468},{"description":"estimated settlements due to 3rd parties","amount":8433178},{"description":"other liabilities","amount":3512709}],"total_liability":50551355},"net_assets_reconciliation":{"total_revenue":159634559,"total_expenses":151122572,"excess_or_deficit_for_year":8511987,"net_unrealized_gains_losses_on_investments":140707,"donated_services_and_facilities":0,"investment_expenses":0,"prior_period_adjustments":0,"other_amount":-11154709,"total_adjustments":-11014002,"excess_or_deficit_per_financial_statements":-2502015},"revenue_reconciliation":{"total_revenue_audited_financial_statements":160104693,"net_unrealized_gains_investments":0,"donated_services_and_use_facilities":0,"recoveries_prior_year_grants":0,"other_revenue":0,"revenue_not_reported":0,"revenue_subtotal":160104693,"investment_expenses_not_included":0,"other_revenues_not_included":-470134,"revenue_not_reported_financial_statement":-470134,"total_revenue_per_990":159634559},"expense_reconciliation":{"total_expenses_audited_financial_statements":151122572,"donated_services_use_facilities":0,"prior_year_adjustments":0,"losses_reported":0,"other_expenses_included":0,"expenses_not_reported":0,"expenses_subtotal":151122572,"investment_expenses_not_included":0,"other_expenses_not_included":0,"expenses_not_reported_financial_statement":0,"total_expenses_per_990":151122572},"supplemental_information":[{"identifier":"SchD_P05_S00_L04","form_and_line_reference":"Schedule D, Part V, Line 4","explanation":"The income from endowed funds is expendable to support healthcare services and nursing scholarships in furtherance of the organization's exempt mission."},{"identifier":"SchD_P10_S00_L01","form_and_line_reference":"Schedule D, Part X, Line 1","explanation":"Liabilities not detailed in Form 990 Part X lines 17 through 24; pension liability, estimated settlements to 3rd parties, etc."},{"identifier":"SchD_P11_S00_L08","form_and_line_reference":"Schedule D, Part XI, Line 8","explanation":"Minimum pension liability adjustment, (9,946,366); Transfers to CD Practice Associates for start up operations, (2,846,621); Transfers from Cooley Dickinson Health Care Corporation to finance property and equipment, 54,266; Net assets released from restriction used for capital additions, 165,000; Change in beneficial interest, temp restricted, 1,418,912; Change in beneficial interest, perm restricted, 100."},{"identifier":"SchD_P12_S00_L04b","form_and_line_reference":"Schedule D, Part XII, Line 4b","explanation":"Non-operating gains, 727,101; Loss on bond refinancing, (1,197,235)"}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":false,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":1345383,"bad_debt_expense_attributable_to_financial_assistance":550716,"reimbursed_by_medicare":36426919,"cost_of_care_reimbursed_by_medicare":44102163,"medicare_surplus_or_shortfall":-7675244,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":3111859,"direct_offsetting_revenue":578056,"net_community_benefit_expense":2533803,"total_expense_percentage":0.0171},"unreimbursed_medicaid":{"total_community_benefit_expense":13503792,"direct_offsetting_revenue":11216345,"net_community_benefit_expense":2287477,"total_expense_percentage":0.0155},"unreimbursed_costs":{"total_community_benefit_expense":4348686,"direct_offsetting_revenue":3019361,"net_community_benefit_expense":1329325,"total_expense_percentage":0.009},"total_financial_assistance":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":20964337,"direct_offsetting_revenue":14813762,"net_community_benefit_expense":6150605,"total_expense_percentage":0.0416},"community_health_services":{"total_community_benefit_expense":1517624,"direct_offsetting_revenue":372262,"net_community_benefit_expense":1145362,"total_expense_percentage":0.0077},"subsidized_health_services":{"total_community_benefit_expense":3439686,"direct_offsetting_revenue":3041275,"net_community_benefit_expense":398411,"total_expense_percentage":0.0027},"cash_and_inkind_contributions":{"total_community_benefit_expense":4569,"direct_offsetting_revenue":0,"net_community_benefit_expense":4569,"total_expense_percentage":0.0},"total_other_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":4961879,"direct_offsetting_revenue":3413537,"net_community_benefit_expense":1548342,"total_expense_percentage":0.0104},"total_community_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":25926216,"direct_offsetting_revenue":18227299,"net_community_benefit_expense":7698947,"total_expense_percentage":0.052}},"community_building":{"health_improvement_advocacy":{"total_community_benefit_expense":3274,"direct_offsetting_revenue":0,"net_community_benefit_expense":3274,"total_expense_percentage":0.0},"total_community_building_activities":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":3274,"direct_offsetting_revenue":0,"net_community_benefit_expense":3274,"total_expense_percentage":0.0}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"Cooley Dickinson Hospital Inc","address_line1":"30 Locust Street","city":"Northampton","state":"MA","zip":"01060","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"Cooley Dickinson Hospital Inc","address":"30 Locust Street, Northampton, MA, 01060"}],"facility_policies":[{"business_name_line1":"Cooley Dickinson Hospital Inc","facility_number":1,"name":"Cooley Dickinson Hospital Inc"}],"supplemental_information":[{"form_and_line_reference":"Schedule H, Part I, Line 3c","explanation":"Service recovery activities occasionally include discounted care."},{"form_and_line_reference":"Schedule H, Part I, Line 7","explanation":"The costing methodology used was the ratio of patient service expense to patient service revenue from the FY2011 Massachusetts Division of Health Care Finance and Policy 403 cost report of Cooley Dickinson Hospital."},{"form_and_line_reference":"Schedule H, Part I, Line 7, Column f","explanation":"Bad debt expense totaling $3,182,317 is included in Form 990, Part IX, line 25, column A, but pursuant to IRS instruction, has been excluded from the expense figure for the purpose of calculating the percentage of total expenses in Schedule H, Part I, line 7, column (f)."},{"form_and_line_reference":"Schedule H, Part II","explanation":"Cooley Dickinson's vision is to make the community it serves the nation's model healthy community. One step toward making that vision real is to include consumer-friendly preventive, screening, or general health information in every issue of the Community Pulse newsletter that the hospital publishes. Some of the health information is linked to the community's health status. For example, heart disease is the leading cause of death in our county and Community Pulse newsletters in 2011 included information about heart attack warning signs, understanding high blood pressure, and eating less and moving more to maintain health. The newsletter also helps promote the health of the community by informing residents of health-related classes, such as a heart-smart cooking class at which healthy recipes were distributed. Cancer is the leading cause of death in two of the larger communities that Cooley Dickinson serves, so other articles explained the importance of colorectal and breast cancer screening and the importance of regular sunscreen use. Injury prevention is also covered in issues of the Community Pulse. In 2011, readers learned how to fit their child with a backpack so as not to cause injury; how to prevent tick bites and dehydration, and how to avoid injuries while gardening."},{"form_and_line_reference":"Schedule H, Part III, Section A, Line 4","explanation":"The audited financial statements for Cooley Dickinson Hospital do not contain a footnote describing bad debt expense. The costing methodology was the ratio of patient service expense to patient service revenue from the FY2011 Massachusetts Division of Health Care Finance and Policy 403 cost report of Cooley Dickinson Hospital."},{"form_and_line_reference":"Schedule H, Part III, Section B, Line 8","explanation":"The full unsubsidized cost of providing care to Medicare patients should be included as a community benefit. The source for line 6 is the Cooley Dickinson Hospital FY2011 Medicare Cost Report."},{"form_and_line_reference":"Schedule H, Part III, Section C, Line 9b","explanation":"The Hospital will not bill patients enrolled in MassHealth, patients receiving governmental benefits under the Emergency Aid to the Elderly, Disabled and Children program, or participants in the Healthy Start program except that the Hospital may bill patients for any co-pays and deductibles required under the program of assistance. The Hospital may initiate billing for a patient who alleges that he or she is a participant in any of these programs but fails to provide proof of such participation (including receipt or verification of signed application). Upon receipt of satisfactory proof that a patient is enrolled in any of the above listed programs, or receipt of the signed application, the Hospital shall cease its collection activities. Participants in the Children's Medical Security Plan (CMSP) whose Family Income is equal to or less than 400% of the Federal Poverty Level (FPL) are also exempt from Collection Action. The Hospital may initiate billing for a patient who alleges that he or she is a participant in the CMSP, but fails to provide proof of such participation. Upon receipt of satisfactory proof that a patient is a participant in the CMSP, the Hospital shall cease all collection activities. Low Income Patients are exempt from Collection Action for any Eligible services received during the period in which they are determined to be Low Income Patients and eligible for payment by the Health Safety Net, except for co-pays and deductibles. Low Income Patients with Family Income between 201 to 400% of the FPL are exempt from Collection Action for the portion of his or her Hospital bill that exceeds the deductible except for Health Safety Net co-payments and deductibles as set forth in 114.6 CMR 13.04. The Hospital may bill for services received outside of the period in which they are determined to be Low Income Patients. The Hospital may bill Low Income Patients for services rendered prior to the Low Income Patient determination, provided that the current Low Income Patient status has been terminated, expired, or not otherwise identified on the state Virtual Gateway or Eligibility Verification System. The Hospital 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. The Hospital may not undertake a Collection Action against an individual that has qualified for Medical Hardship under the Massachusetts Health Safety Net program with respect to the amount of the bill that exceeds the Medical Hardship contribution. The Hospital will further cease any collection efforts against an emergency bad debt claim that is approved for Medical Hardship under the Health Safety Net program. The Hospital 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, provided that the state of Massachusetts will file its own recovery action for those patients enrolled in MassHealth or the Health Safety Net. The Hospital complies with all applicable billing requirements including those in the Department of Public Health regulations (105 CMR 130.332) for non payment of services or readmissions that the Hospital determines to be a result of a Serious Reportable Event (SRE). SREs that do not occur at the Hospital are excluded from this determination of non-payment. Additionally, the Hospital does not bill low income patients eligible for the Health Safety Net when claims are denied by an insurance company as a result of an administrative billing error by the Hospital."},{"form_and_line_reference":"Schedule H, Part VI, Line 2","explanation":"Cooley Dickinson Hospital designates the Healthy Communities Committee to oversee the assessment. The Committee is a Board committee and includes Board members, staff, and community representatives. The health assessment project is staffed by the Western Massachusetts Center for Healthy Communities, a program of Cooley Dickinson Hospital. There are two main goals of the committee, with respect to the assessment: 1) Evaluate existing community programs; 2) Assess community needs and design programming and interventions based on findings. The Committee confirmed the major categories for community benefit programs as follows: 1) Health access; 2) Health equity; 3) Healthcare reform; 4) Chronic disease; 5) Behavioral Health; 6) Healthy eating and active living. Programs within these categories were reviewed and scored with regard to criteria such as fit with Healthy Communities mission, Hospital's service area, clinical priorities, community need, focus on a specific target population (e.g. uninsured, elderly, poor, racial, linguistic, ethnic minority, etc.). Each program was asked to complete a detailed questionnaire about program operations and outcomes and met with two or three committee members to review and discuss the responses. The committee rank ordered programs based on the above criteria and made decisions about priorities for continued inclusion as a community program. This process is formally completed every other year and was last completed for all programs in fiscal year 2010 and is scheduled again for 2012. The major health assessment focus for 2011 was completion and public dissemination of a comprehensive community health assessment. The rationale selected for the design of the assessment is that chronic diseases account for 70% of all deaths in the nation, whereas diabetes, heart disease, and certain types of cancer are largely preventable with changes in lifestyle and behavior. Further, the committee oriented the assessment to focus on the social determinants of health because research shows that behavior is influenced by environmental conditions such as local policy, systems, and culture. Social determinants may include housing, access to services and transportation, affordability of healthy food, quality of education, and so on. The design for the health assessment included several phases. The first phase is a comprehensive review of secondary health data in existing local, state, and national databases. The 66-page report includes sections on demographics, birth and death, chronic disease, substance abuse, food and fitness, and health care access. Demographic indicators: Population; Income and employment; Education; Language and civic engagement; Birth and Death indicators (Mortality; Infant mortality; Low birth weight; Teen birth rate). Chronic Disease Indicators: Cancer incidence and mortality; Breast cancer; Prostate cancer; Lung cancer; Colon cancer; Adult asthma; Childhood asthma; Cholesterol; Diabetes; Heart disease high blood pressure; Stroke; Perception of health. Substance Abuse Indicators: Youth substance use; Tobacco use. Food and Fitness Indicators: Food and fitness environment; Health behaviors; Adults overweight and obesity; Childhood overweight and obesity. Health Care Access: Latino Health Care assessment; Barriers to health care. The health assessment findings were disseminated to the public at a community forum in March, 2011, at smaller forums for community programs, in the media, and via the Hospital's website. Copies were distributed to all Board members and made widely available to community based programs. In phase two, the health assessment design includes collecting primary data using qualitative methods such as surveys, interviews, meetings, and events. A community survey, which focused broadly on food and fitness issues, was begun in 2010 and the results were disseminated in 2011, including via the Hospital's website."},{"form_and_line_reference":"Schedule H, Part VI, Line 3","explanation":"Cooley Dickinson Hospital posts signs in the inpatient, clinic, and emergency admissions/registration areas and in business office areas that are customarily used by patients that conspicuously inform patients of the availability of financial assistance programs and the Hospital location at which to apply for such programs. All signs and notices are translated into English and Spanish. The signs notify patients of the availability of financial assistance and of other programs of public assistance. Hampshire HealthConnect (HHC), a Cooley Dickinson Hospital based program, has a mission to help uninsured and underinsured people access health coverage and care. HHC case managers assist uninsured patients to enroll with MassHealth, Health Safety Net and other state healthcare programs. HHC also administers the Hampshire Health Physician Network, a group of local physicians who offer health care to local residents who are low income and cannot qualify for MassHealth or other health insurance. Participating physicians agree to accept reduced fees and are not reimbursed by the Health Safety Net for their services. HHC flyers are distributed to all self pay patients in the emergency department and throughout the Hospital. The Hospital provides an individual notice of the availability of financial assistance programs, including Medical Hardship, to patients expected to incur charges. The Hospital will include a notice about eligible services to Low Income Patients and programs of public assistance in its initial bill and in all written collection actions stating: \"If you are unable to pay this Hospital bill, you may be eligible for coverage through a financial assistance program. Enrollment in many programs is time-sensitive, so please contact our Hampshire HealthConnect Department as soon as possible. To speak with someone in the Hampshire HealthConnect Department, please call (413) 582-2848, Monday through Friday 9:00 am to 5:00 pm. You may also obtain information at the Cashier's Office located in the main entrance of the Hospital.\""},{"form_and_line_reference":"Schedule H, Part VI, Line 4","explanation":"Cooley Dickinson Hospital (CDH) serves a population (2010) of 136,383 residents of Hampshire and Franklin counties in the Pioneer Valley region of Massachusetts. Its primary service area (PSA) is comprised of 15 Hampshire and one Franklin community and secondary service area (SSA) of five Hampshire and six Franklin communities. The PSA includes the following communities from which 50 percent or more of inpatient hospital admissions were to CDH for the three years from fiscal 2008 through fiscal 2010. Amherst, Chesterfield, Cummington, Easthampton, Florence, Goshen, Hadley, Hatfield, Haydenville, Leeds, North Amherst, North Hatfield, Northampton, West Hatfield, Whately, Williamsburg. The following communities, from which 25 percent of more of inpatient hospital admissions were to CDH for the three-year period, comprise the SSA. Belchertown does not meet the 25 percent share threshold, but is included because it has the seventh highest volume of discharges. Ashfield, Belchertown, Huntington, Leverett, Plainfield, Shutesbury, South Deerfield, Southampton, Sunderland, West Chesterfield, and Worthington. Population Trends, Overall; The PSA population is expected to decline by 0.37 percent by 2015 after growing by 1.7 percent from 2000 to 2010. Growth of 0.70 percent is expected for the SSA, according to population data from ESRI Business Information Solutions. This projected stability follows a period of growth, by 4.67 percent, of the SSA population between 2000 and 2010. Factors of interest in planning hospital services and projecting use of hospital services are highlighted below. Aging; The service area is graying, consistent with national trends. * 11.79 percent of the PSA population and 11.71 percent of the SSA was 65 or older in 2010. These rates are lower than for Massachusetts (13.8 percent) and the United States (13 percent). (By 2015, 13.84 percent of the PSA population and 14.62 percent of the SSA is expected to be 65+; for Massachusetts the percentage will be 15.3 and US, 14.43). * The age cohorts starting at traditional retirement age (65) are growing the fastest. The compound annual growth rate for area residents 65-79 is 5.51 percent in the primary service area and 6.38 percent in the secondary service area. (This means that by 2015, there will be 2,328 more 65-79 year-olds in the PSA and 1,177 more in the SSA). * By contrast, the number of residents in the primary and secondary service areas at the upper end of the age spectrum is expected to decline by 2015. The population age 80+ will have a negative compound annual growth rate, amounting to 400 fewer adults 80 or older (351 in the PSA alone) by 2015. * Children and Young Adults; The population up to age 14 and that 15-24 will both decline by 2015, amounting to 215 fewer children (133 from PSA; 82 from SSA) and 1,469 fewer young adults (1,212 from PSA and 257 from SSA). The decline in the population under 24 is not surprising given lower birth rates in our service area. Rates are reported by the Massachusetts Department of Public Health for the state and state-defined community health network areas in our region and compared to the US rate reported by the National Center for Health Statistics. The Franklin rate of 9.2 is higher than it was in 2008 (8.8 births per 1000 residents), while the Hampshire rate of 7.1 - the lowest among Massachusetts community health networks in 2009 - declined from 8.0 in 2008. The Massachusetts rate of 11.4 was down slightly from 11.8 in 2008. Demographic Profile of Service Area Income; The communities Cooley Dickinson serves have higher median household incomes than Hampshire and Franklin counties, Massachusetts, and the nation, according to ESRI and US Census data. The US rate is $50,046; Franklin County, $52,002; Hampshire County, $58,449; Cooley Dickinson Primary Service Area, $61,625; Massachusetts, $62,072; CDH Combined Service Area, $64,187; and CDH Secondary Service Area, $70,392. The range of median household incomes in the PSA in 2010 was from $43,148 in North Amherst to $82,139 in the 01063 zip code in Northampton, the Smith College neighborhood. For the SSA, the range is from $48,002 in Sunderland to $89,849 in Southampton. The US census has not yet released 2010 information about residents living below the poverty level for all communities in the service area. Two of the four areas for which data is available report rates well above the 2010 Massachusetts percentage of 10.5 percent of residents living below poverty level and US rate, 13.8 percent. They are Amherst Center (30.8 percent) and North Amherst (43 percent). The rate for Northampton is 13.1 percent and for Easthampton, 6.2 percent. The toll of the recession is evident here: the 2000 Census reported the percentages of people living below the poverty level as 6.7 in Massachusetts and 9.2 in the nation. Race and Ethnicity; The Census Bureau has developed a Diversity Index to compute the differences in diversity among populations. The Diversity Index is expressed as a ratio and reports the percentage of times two randomly selected people would differ by race/ethnicity. An area's Diversity Index would be 1.0 when the population is evenly divided into two or more race/ethnic groups. According to ESRI, the 2010 Diversity Index for the United States was 0.60 (55.51 in the Northeast). The CDH service area is becoming increasingly diverse. For the Primary Service Area, the Diversity Index is 0.30, expected to increase to 0.33 by 2015, with a compound annual growth rate of 1.87 percent. While the Secondary Service Area was less diverse in 2010 (0.13), it is expected to diversify more, with a compound annual growth rate of 3.14, by 2015 than the PSA. In 2000, 97 percent of PSA residents and 95 percent of SSA residents were white. Those percentages declined to 83 and 93 percent, respectively, by 2010 and are expected to be 81 and 92 by 2015. It is expected there will be 2,208 fewer white residents in the PSA and 218 less in the SSA. The next largest group in the PSA was Asian in 2000 (4.62 percent of the population) and Hispanic in the SSA (1.5 percent); in both service areas, Hispanic was second in 2010. By 2015, the Hispanic population in the PSA is expected to increase from 6.2 percent of the 2010 population to 7.25 percent, representing an increase of 1,017 individuals. The percentages of the Black and Asian populations are expected to grow by less than 1 percent by 2015, with net increases of 288 and 275 persons. Diversity changes in the SSA include Hispanic population growth from 2.29 to 2.79 percent, representing 194 individuals. More growth is expected in the Asian SSA population, from 1.92 to 2.24 percent, or 126 persons. Cooley Dickinson spent more than $388,000 on medical interpreter services during the year to assist non-English speaking patients."},{"form_and_line_reference":"Schedule H, Part VI, Line 4 (Cont.)","explanation":"Recession Impact; Despite that the CDH service area income is relatively high, a snapshot of data from the Massachusetts Division of Insurance shows the economic slowdown has affected the insurance coverage that area residents carry. Insurance enrollment by county as of the quarter ending Sept. 30 for 2009, 2010, and 2011 indicates a shift from commercial HMOs and the Commonwealth Connector program to Medicaid. Enrollment in commercial HMOs declined by 7 percent in both Hampshire and Franklin counties between 2009 and 2011. Enrollment in the Commonwealth Connector program increased over that period by 3.24 percent in Hampshire and 8 percent in Franklin County. Medicaid saw double digit increases from 2009 to 2011, 14 percent in Hampshire County and 22 percent in Franklin. Educational Attainment; Cooley Dickinson serves a population with higher levels of educational attainment than Massachusetts and the nation. Fifty percent of PSA residents have a college degree or higher, compared to 38 percent for Massachusetts and 27 percent U.S. Employment; Not surprisingly given the educational attainment of residents of the service area, the occupational makeup of the population differs from that of the nation. Educational services and health care are the largest employment sectors in Hampshire and Franklin counties. In the United States, 23.24 percent of the population is employed in education, health care, and social assistance. That rate is higher (28.69 percent) in Hampshire County and lower (21.53 percent) in Franklin. Both Hampshire and Franklin Counties have lower percentages than the nation of people employed in the second largest sector, retail trade (US 11.65 percent; Hampshire 8.88 percent; and Franklin 8.47 percent). (US Census; counties, Economic Development Data & Information for Connecticut and Western Massachusetts [EDDI]). The top 10 employers in Hampshire and Franklin Counties include three health facilities, including Cooley Dickinson, and nine educational facilities, including five colleges, two private secondary schools, and two public school districts. Service Area Health Status; The Cooley Dickinson Community Health Assessment, published March 2011, provides detailed data about health status in Hampshire and Franklin Counties. Residents of the Cooley Dickinson Hospital service areas are generally healthier than the population of Massachusetts and the United States. The federal Community Health Status Reports for 2009 for Hampshire and Franklin Counties indicate better average life expectancy, fewer deaths per 100,000 residents, and lower rates of self-reported fair or poor health than the United States. In both counties, the rate of reported unhealthy days in the previous month was slightly higher than the U.S. median. The reports also compare both counties on 19 indicators of health to both the United States and a group of peer counties. Hampshire County's results are better than both the U.S. and peer counties on 16 of the indicators. Franklin County's results are better than both for 10 indicators. The two counties share unfavorable data compared to peers and the United States on three indicators: births to women age 40-54, breast cancer, and colon cancer. Franklin also has unfavorable rates of very low birth weight babies. As described in the hospital's Community Needs Assessment, a deeper look at the health status data reveals increasing obesity rates, increasing diabetes rates, and disparities in asthma prevalence (based on location). Access to Care; Cooley Dickinson is one of two not-for-profit hospitals in Hampshire County. The second, Baystate Mary Lane Hospital, is 50 minutes to 1 hour driving time away from Cooley Dickinson. Baystate Health also has facilities about 30 minutes away in northern Franklin County's Greenfield and south of the Cooley Dickinson service area in Hampden County's Springfield. The U.S. Health Resources and Services Administration has designated three communities (Chesterfield, Cummington, and Williamsburg) in Cooley Dickinson's primary service area and four (Ashfield, Huntington, Plainfield, and Worthington) in the secondary service area as Medically Underserved Areas (MUAs). A corporate affiliate, CD Practice Associates, employs two primary care physicians and a nurse practitioner in one of the MUAs, Williamsburg, and the hospital provides rehabilitation services in another, Worthington. In addition, US HRSA has designated one primary service area community (Whately) and three secondary service area communities (Leverett, Shutesbury, and Sunderland) as having Medically Underserved Populations (MUPs). While CD Practice Associates does not have providers located in Sunderland, its primary care providers have 1,261 of Sunderland's 3,781 residents as patients. Massachusetts' health insurance mandate means the percentage of uninsured residents in the service area is low. Nevertheless, the hospital provides a safety net for the uninsured and underinsured through some use of the emergency department for primary care - approximately 10 percent of visits - and actively seeks to enroll patients and residents in coverage through Hampshire Health Connect. The value of Free Care provided in fiscal 2011 was $4,833,037."},{"form_and_line_reference":"Schedule H, Part VI, Line 5","explanation":"Cooley Dickinson Hospital's mission, \"To provide our patients and communities with the best health care in the most appropriate environment,\" is carried out by 315 physicians and more than 1,600 employees, including 348 nurses, and 400 volunteers. Together, they cared for 81,234 community members in the year ending Sept. 30, 2011. The medical staff of Cooley Dickinson is organized in the public interest. Medical staff privileges are available to all qualified physicians in the community for all of our departments. In addition, the hospital furthered its exempt purpose through partnerships with our affiliated organization, VNA & Hospice of Cooley Dickinson, and community organizations, ranging from Aging Services Access Points and Councils on Aging to long-term care facilities and boards of health. With these partnerships, we worked toward achieving the best health care through projects such as coordinating care for residents with complex medical and psychosocial issues to improve the quality of life of those residents and prevent their avoidable use of health care services. These partnerships are in addition to those created through the processes of assessing community health needs and developing and implementing our community benefits plan. Funds the hospital generates are reinvested in programs or services that meet the healthcare needs of the community, promote improved health, or prevent illness or injury. For example, in 2011, the hospital published four issues of its Community Pulse newsletter, which provides health prevention and screening information to encourage residents to maintain or improve their health. The hospital also invested funds - to name a few examples - to increase access to primary care physicians and allied health professionals to meet community need; to upgrade equipment for patients requiring cardiac and pulmonary rehabilitation; and to invest in electronic medical records to improve coordination and safety of care. Cooley Dickinson focuses on responsiveness to the healthcare needs of our community. When surveyed in 2010, residents report we succeed at that goal, rating us 3.55 on a 4.0 scale on how well we respond to needs. This research will be repeated in Fiscal 2012 to ensure community members still find the hospital responsive. Strong community involvement in our organization is also demonstrated by the fact that 73 percent of the 22 voting members of the Board of Trustees are independent (the president and three physician trustees are employees of the organization; two other physician trustees are contractors). A total of 95 percent of the current of trustees live in the hospital's primary or secondary service area. In addition, other residents are involved as volunteers through the Board of Trustees' Healthy Communities and Development and Public Relations Committees. A Patient and Family Advisory Council, consisting of additional residents, is involved in decisions regarding their non-profit community hospital."},{"form_and_line_reference":"Schedule H, Part VI, Line 6","explanation":"Cooley Dickinson Hospital, Inc. (the \"Hospital\") is an acute care, not-for-profit 140 bed community hospital located in Northampton Massachusetts and a wholly owned subsidiary of Cooley Dickinson Health Care Corporation (the \"Corporation\"). The Hospital provides a broad range of patient services and a number of health related community services, including acute and critical medicine, surgery, psychiatry, and rehabilitation. The Corporation provides fund raising support and maintains donor-restricted funds for the benefit of the Hospital. Other related entities of the Hospital include CD Practice Associates, Inc. (\"CDPA\"), a not-for-profit organization established to own and manage operating groups of physicians; and VNA and Hospice of Cooley Dickinson, Inc. (\"VNA/Hospice\"), a not-for-profit organization established to provide home health and hospice care services."},{"form_and_line_reference":"Schedule H, Part VI, Line 7","explanation":"Cooley Dickinson Hospital annually files a Community Benefits report with the Office of the Attorney General of the Commonwealth of Massachusetts."}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":25000,"reported_domestic_individual_grants":0,"reported_domestic_org_grants_program_services":25000,"reported_domestic_individual_grants_program_services":0,"total_501c3_and_government_organizations":2,"total_other_organizations":0,"grants":[{"ein":42562893,"cash":7500,"noncash":0,"purpose":"To provide an infrastructure that will build capacity for local leadership to effect change at the system and policy levels in Hampshire County around food and fitness. This includes increases in and access to healthy eating and physical activity for children, families and adults, and in particular for underserved populations such as low income residents and recent immigrants.","address_line1":"97 Hawley Street","address_line2":"Attn Sue Cairn","city":"Northampton","state":"MA","zip":"01060","name":"SPIFFY","address":"97 Hawley Street, Attn Sue Cairn, Northampton, MA, 01060"},{"ein":46001424,"cash":7500,"noncash":0,"purpose":"To allow the Communities That Care Coalition to transition from a focus on youth substance abuse prevention to a broader healthy communities focus, capitalizing on established membership, structures, and experience while adding new partners, goals, objectives, and strategies.","address_line1":"425 Main Street Suite 20","city":"Greenfield","state":"MA","zip":"01301","name":"Community Coalition for Teens","address":"425 Main Street Suite 20, Greenfield, MA, 01301"}],"total_domestic_grants":25000,"total_domestic_program_services":25000,"detail_org_grants_total":15000,"detail_domestic_grants_total":15000,"supplemental_information":[{"identifier":"SchI_P01_S00_L02","form_and_line_reference":"Schedule I, Part I, Line 2","explanation":"The grant recipient provided a presentation to the Board of Trustees Subcommittee for Healthy Communities. Recipients are also expected to submit a written annual report to the Committee."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"The grant recipient provided a presentation to the Board of Trustees Subcommittee for Healthy Communities. Recipients are also expected to submit a written annual report to the Committee.","form_and_line_reference":"Schedule I, Part I, Line 2"}},"ScheduleF":{"reported_foreign_grants":0,"reported_foreign_grants_program_services":0},"ScheduleJ":{"benefits_and_procedures":{"housing_allowance_or_residence":true,"substantiation_required":true,"written_policy_travel_and_entertainment":false},"compensation_process":{"compensation_committee":true,"independent_consultant":true,"compensation_survey_or_study":true,"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":true,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"Craig N 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The benefits were then paid in accordance with the contract."},{"identifier":"SchJ_P01_S00_L01b","form_and_line_reference":"Schedule J, Part I, Line 1b","explanation":"The housing allowance benefit was included in a contract that was negotiated and approved by the Chief Executive Officer and the Vice President of Human Resources. The benefits were then paid in accordance with the contract."},{"identifier":"SchJ_P01_S00_L04","form_and_line_reference":"Schedule J, Part I, Line 4","explanation":"The organization offers a Supplemental Retirement Plan (SRP) for Senior Executives. Annually, the organization provides the SRP benefit contribution amounts to the participant. The benefit contribution amounts for 2010 are as follows: Craig Melin $70,683; Carol Smith $19,368; Edith Peter $21,551; Leesa-Lee Keith $6,043. Kenneth Guilbault received severance payments totaling $30,881."},{"identifier":"SchJ_P02_S00_L00","form_and_line_reference":"Schedule J, Part II","explanation":"Other reportable compensation, Column B(iii), may include Supplemental Retirement Plan benefit contributions, employee deferrals to Section 457 plans, taxable life or disability, and the taxable benefit of an employer provided automobile."}]},"ScheduleK":{"bond_issues":[{"issuer_ein":[42456011,42456011],"business_name_line1":["Massachusetts Health and Educational Facilities Authority","Massachusetts Health and Educational Facilities Authority"],"cusip_number":["none00000","none00000"],"date_issued":["2007-09-17T00:00:00","2009-02-20T00:00:00"],"issue_price":[1488727,3125000],"purpose":["surgical equipment","building renovations & equipment"],"defeased":[false,false],"on_behalf_of_issuer":[false,false],"pool_financing":[false,false],"name":"['Massachusetts Health and Educational Facilities Authority', 'Massachusetts Health and 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paid to the Massachusetts Hospital Association (MHA) and the American Hospital Association (AHA), supports the lobbying activities carried out by these organizations. MHA and AHA have reported to Cooley Dickinson Hospital the portion of the dues that are used for lobbying purposes on behalf of member hospitals."}]},"ScheduleD":{"endowment_funds":{"current_year":{"beginning_year_balance":4382624,"contributions":100,"investment_earnings_or_losses":513734,"grants_or_scholarships":949,"other_expenditures":83186,"administrative_expenses":0,"end_year_balance":4812323},"current_year_minus1":{"beginning_year_balance":3879597,"contributions":0,"investment_earnings_or_losses":582197,"grants_or_scholarships":1131,"other_expenditures":78039,"administrative_expenses":0,"end_year_balance":4382624},"current_year_minus2":{"beginning_year_balance":3953056,"contributions":100,"investment_earnings_or_losses":8786,"grants_or_scholarships":1395,"other_expenditures":80950,"administrative_expenses":0,"end_year_balance":3879597},"current_year_minus3":{"beginning_year_balance":3892904,"contributions":150,"investment_earnings_or_losses":125417,"grants_or_scholarships":1500,"other_expenditures":63915,"administrative_expenses":0,"end_year_balance":3953056},"current_year_minus4":{"beginning_year_balance":3913781,"contributions":10720,"investment_earnings_or_losses":30998,"grants_or_scholarships":1100,"other_expenditures":61495,"administrative_expenses":0,"end_year_balance":3892904},"board_designated_eoy_percentage":0.4,"permanent_endowment_eoy_percentage":0.11,"term_endowment_eoy_percentage":0.49,"held_by_unrelated_organizations":false,"held_by_related_organizations":true,"related_organizations_listed_schedule_r":true},"land_buildings_equipment":{"land":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":2029000,"book_value":2029000},"buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":63332957,"book_value":39949187,"depreciation":23383770},"leasehold_improvements":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":54336960,"book_value":20147438,"depreciation":34189522},"equipment":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":88003551,"book_value":12250423,"depreciation":75753128},"other_land_buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":3289131,"book_value":1639713,"depreciation":1649418},"total_book_value":76015761},"other_assets":{"assets":[{"description":"beneficial 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the organization's exempt mission."},{"identifier":"SchD_P10_S00_L02","form_and_line_reference":"Schedule D, Part X, Line 2","explanation":"The organization did not have a FIN48 liability, therefore a footnote was not needed in the audited financial statements."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":false,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":1463754,"bad_debt_expense_attributable_to_financial_assistance":521654,"reimbursed_by_medicare":41745194,"cost_of_care_reimbursed_by_medicare":41971910,"medicare_surplus_or_shortfall":-226716,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":2800445,"direct_offsetting_revenue":515779,"net_community_benefit_expense":2284666,"total_expense_percentage":0.0152},"unreimbursed_medicaid":{"total_community_benefit_expense":14682797,"direct_offsetting_revenue":12285751,"net_community_benefit_expense":2397046,"total_expense_percentage":0.016},"unreimbursed_costs":{"total_community_benefit_expense":4496674,"direct_offsetting_revenue":3377476,"net_community_benefit_expense":1119198,"total_expense_percentage":0.0075},"total_financial_assistance":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":21979916,"direct_offsetting_revenue":16179006,"net_community_benefit_expense":5800910,"total_expense_percentage":0.0387},"community_health_services":{"total_community_benefit_expense":1813477,"direct_offsetting_revenue":380988,"net_community_benefit_expense":1432489,"total_expense_percentage":0.0095},"health_professions_education":{"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"subsidized_health_services":{"total_community_benefit_expense":4382577,"direct_offsetting_revenue":3370591,"net_community_benefit_expense":1011986,"total_expense_percentage":0.0067},"total_other_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":6196054,"direct_offsetting_revenue":3751579,"net_community_benefit_expense":2444475,"total_expense_percentage":0.0162},"total_community_benefits":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":28175970,"direct_offsetting_revenue":19930585,"net_community_benefit_expense":8245385,"total_expense_percentage":0.0549}},"community_building":{"health_improvement_advocacy":{"total_community_benefit_expense":18635,"net_community_benefit_expense":18635,"total_expense_percentage":0.0001},"total_community_building_activities":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":18635,"direct_offsetting_revenue":0,"net_community_benefit_expense":18635,"total_expense_percentage":0.0001}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"Cooley Dickinson Hospital Inc","address_line1":"30 Locust Street","city":"Northampton","state":"MA","zip":"01060","website":"cooley-dickinson.org","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"Cooley Dickinson Hospital Inc","address":"30 Locust Street, Northampton, MA, 01060"}],"facility_policies":[{"business_name_line1":"Cooley Dickinson Hospital Inc","facility_number":1,"chna_conducted":true,"community_definition":true,"community_demographics":true,"how_data_obtained":true,"community_health_needs":true,"other_health_issues":true,"community_health_needs_identification_process":true,"consulting_process":true,"chna_conducted_year":13,"took_into_account_others_input":true,"chna_conducted_with_other_facilities":true,"chna_report_widely_available":true,"report_available_on_own_website":true,"paper_copy_public_inspection":true,"implementation_strategy_adopted":true,"strategy_posted_website":true,"organization_incurred_excise_tax":false,"adopt_budget":true,"all_needs_addressed":false,"eligibility_criteria_explained":true,"fpg_family_income_limit_free_discounted":true,"fpg_family_income_limit_free_care_percentage":200.0,"fpg_used_determine_discounted_care":false,"basis_explained":false,"application_financial_assistance_explanation":true,"other_method_used":true,"includes_publicity_measures":true,"fap_available_on_website":true,"fap_available_on_request_no_charge":true,"fap_actions_on_nonpayment":true,"attached_to_invoice":true,"posted_in_admission_office":true,"posted_in_emergency_room":true,"provided_on_admission":true,"collection_activities":false,"nondiscriminatory_emergency_care_policy":true,"amounts_generally_billed":false,"gross_charges":false,"prioritize_health_needs":true,"name":"Cooley Dickinson Hospital Inc"}],"supplemental_information":[{"form_and_line_reference":"Schedule H, Part I, Line 3c","explanation":"Service recovery activities occasionally include discounted care."},{"form_and_line_reference":"Schedule H, Part I, Line 7","explanation":"The costing methodology used was the ratio of patient service expense to patient service revenue from the FY2013 Massachusetts Division of Health Care Finance and Policy 403 cost report of Cooley Dickinson Hospital"},{"form_and_line_reference":"Schedule H, Part I, Line 7f","explanation":"Bad debt expense totaling $3,663,291 is included in Form 990, Part IX, line 25, column A, but pursuant to IRS instruction, has been excluded from the expense figure for the purpose of calculating the percentage of total expenses in Schedule H, Part I, line 7, column (f)."},{"form_and_line_reference":"Schedule H, Part II","explanation":"Cooley Dickinsons vision is to make the the Pioneer Valley the nations model healthy community. One step toward making that vision real is to include consumer friendly, preventive, screening, or general health information in every issue of the The Pulse newsletter that the hospital publishes. Some of the health information is linked to the communitys health status. For example, the incidence of stroke is higher among men and women in both Hampshire and Franklin counties yet are below the Massachusetts average for the majority of years between 1999 to 2008. In 2013, one issue of The Pulse told the story of an Easthampton womans efforts to overcome the effects of a stroke. Reporting also included a checklist for stroke risk factors (Stroke: Could I Be at Risk?). An infographic outlined facts related to stroke and reminded readers that up to 80 percent of strokes can be prevented by controlling these risk factors. Finally, Cooley Dickinson repurposed stroke.orgs FAST messaging to highlight stroke symptoms and warning signs. Providing preventive health and community education is also an important objective of the Pulse. In 2013, parents were offered reminders about keeping their children healthy and safe during the winter months. Readers had access to an online quiz to test their knowledge about bike helmets and bike safety. And they learned about the Cooley Dickinson:Massachusetts General Hospital collaboration through lectures that features advances in treatment and health care delivery, health policy issues of the day, and medical research. (There were seven lectures in 2013 and five were promoted in The Pulse in addition to other media. Finally, consumer research reflects a trend of increased readership, especially since the distribution of The Pulse changed from newspaper insert to direct mail. In the most recent research, nearly a quarter of respondents are aware of the newsletter and, among those, 49 percent of the consumers said they read all, most, or some of the publication"},{"form_and_line_reference":"Schedule H, Part III, Section A, Line 4","explanation":"Cooley Dickinson Hospital, Inc. is included in the consolidated audited financial statements of Partners HealthCare System, Inc. and Affiliates. The footnote in the Partners HealthCare consolidated audited financial statements reads: In addition to free care and inadequate funding from the Medicaid and Medicare programs, there are significant losses related to self pay patients who fail to make payment for services rendered or insured patients who fail to remit copayments and deductibles as required under the applicable health insurance arrangement. The provision for bad debts of $102,409,000 in 2013 and $123,725,000 in 2012 represents charges for services provided that are deemed to be uncollectible. The estimated cost of providing these services was approximately $38,205,000 and $39,936,000 for 2013 and 2012, respectively."},{"form_and_line_reference":"Schedule H, Part III, Section B, Line 8","explanation":"The full unsubsidized cost of providing care to Medicare patients should be included as a community benefit. The source for line 6 is the Cooley Dickinson Hospital FY2013 Medicare Cost Report."},{"form_and_line_reference":"Schedule H, Part III, Section C, Line 9b","explanation":"The Hospital will not bill patients enrolled in MassHealth, patients receiving governmental benefits under the Emergency Aid to the Elderly, Disabled and Children program, or participants in the Healthy Start program except that the Hospital may bill patients for any co-pays and deductibles required under the program of assistance. The Hospital may initiate billing for a patient who alleges that he or she is a participant in any of these programs but fails to provide proof of such participation (including receipt or verification of signed application). Upon receipt of satisfactory proof that a patient is enrolled in any of the above listed programs, or receipt of the signed application, the Hospital shall cease its collection activities. Participants in the Childrens Medical Security Plan (CMSP) whose Family Income is equal to or less than 400% of the Federal Poverty Level (FPL) are also exempt from Collection Action. The Hospital may initiate billing for a patient who alleges that he or she is a participant in the CMSP, but fails to provide proof of such participation. Upon receipt of satisfactory proof that a patient is a participant in the CMSP, the Hospital shall cease all collection activities.Low Income Patients are exempt from Collection Action for any Eligible services received during the period in which they are determined to be Low Income Patients and eligible for payment by the Health Safety Net, except for co-pays and deductibles. Low Income Patients with Family Income between 201 to 400% of the FPL are exempt from Collection Action for the portion of his or her Hospital bill that exceeds the deductible except for Health Safety Net co-payments and deductibles as set forth in 114.6 CMR 13.04. The Hospital may bill for services received outside of the period in which they are determined to be Low Income Patients. The Hospital may bill Low Income Patients for services rendered prior to the Low Income Patient determination, provided that the current Low Income Patient status has been terminated, expired, or not otherwise identified on the state Virtual Gateway or Eligibility Verification System. The Hospital 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 patients prior written consent to be billed for the service. The Hospital may not undertake a Collection Action against an individual that has qualified for Medical Hardship under the Massachusetts Health Safety Net program with respect to the amount of the bill that exceeds the Medical Hardship contribution. The Hospital will further cease any collection efforts against an emergency bad debt claim that is approved for Medical Hardship under the Health Safety Net program. The Hospital 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, provided that the state of Massachusetts will file its own recovery action for those patients enrolled in MassHealth or the Health Safety Net. The Hospital complies with all applicable billing requirements including those in the Department of Public Health regulations (105 CMR 130.332) for non payment of services or readmissions that the Hospital determines to be a result of a Serious Reportable Event (SRE). SREs that do not occur at the Hospital are excluded from this determination of non-payment. Additionally, the Hospital does not bill low income patients eligible for the Health Safety Net when claims are denied by an insurance company as a result of an administrative billing error by the Hospital."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 3","explanation":"When we conducted our most recent CHNA, we solicited input from community members in several ways. We collected data from community members through an on-line and paper-based survey intended to capture needs in broad categories for further study. The survey was not designed nor intended to be scientifically based (i.e. random respondents). The number of responses, 962, was higher than we had expected. The survey identified gaps in the care system for vulnerable populations such as people living in poverty and people whose primary language is not English. The survey also found gaps in services for the mentally ill and people with substance use disorders. The survey also confirmed concerns we had about higher than expected rates of heart disease and cancer in one community. We interviewed several community leaders to learn about their key concerns and to identify themes. Based on the survey and key informant interview findings, coupled with our earlier report about health status indicators, we conducted three focus groups: health access (including transportation); mental health, Easthampton health issues. Focus group participants were recruited from a range of places and were typically community members who use services. Based on focus group feedback, we next conducted three community forums on these topics. The forums allowed for open discussion between residents, service recipients, and agency representatives to refine findings and shape next steps. We collaborated with local health department directors and agency directors. The consulted organizations include: Amherst Health Department; Easthampton Health Department; Ambulatory Care Physicians at CDH, Inc.; Valley Medical Group; Community Action; Clinical & Support Options; Stavros; Tapestry; Highland Valley Elder Services; Northampton Survival Center; Amherst Survival Center; ServiceNet; National Alliance for the Mentally Ill, Western Massachusetts; and Easthampton Community Center."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 4","explanation":"We worked with six other hospitals in the Pioneer Valley to develop the CHNA and we all used the same survey instrument and methods. We hired our own consultants to conduct key informant interviews and focus groups. The hospitals all collaborated to produce a video showing the benefits of forming a partnership to conduct a regional health assessment. The hospitals all also agreed to develop one regional project together. The other facilities are: Baystate Medical Center, Baystate Franklin Medical Center, Baystate Mary Lane Hospital, Holyoke Medical Center, Mercy Medical Center, and Wing Memorial Hospital."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 7","explanation":"We addressed most of the needs identified in the CHNA, including all of the major ones. We did not address asthma. Asthma rates, in our earlier CHNA, appeared to be higher than expected in some schools in some communities. Upon further investigation we have discovered that the accuracy of school-based reporting varies considerably and that the data are of limited value. Asthma was not chosen as a priority for further action in part based on the uncertainty about the data. When and if reporting is more standardized and uniformly reliable, our next CHNA may show asthma as an important issue to address. The primary needs that were revealed through the CHNA that are addressing with a range of community partners are: health access; health access for the Latina population; transportation and access to health services; gaps and lack of coordination in the mental health/addiction community continuum of care; youth substance abuse; and the need to assist Easthampton to improve rates of healthy eating/active living and reduce rates of tobacco use."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 11","explanation":"The Hospital does not have a discounted care policy."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 18","explanation":"The Hospitals billings and collections did not engage in any actions such as reporting to credit agencies, lawsuits, liens on residences, body attachments, or other similar actions."},{"form_and_line_reference":"Schedule H, Part V, Section B, Line 20","explanation":"The Hospital charges all patients uniformly regardless of insurance coverage. For patients that are FAP eligible, the only bill they will receive from the Hospital is the amount due as determined by the insurance program that they qualify for through the state."},{"form_and_line_reference":"Schedule H, Part VI, Line 2","explanation":"Cooley Dickinson Hospital assesses the needs of the communities we serve using several methods. We compiled a report of health status indicators covering chronic disease, demographics, birth and death, substance abuse, food and fitness, and access to care. We published this report in 2011. The report includes detailed data including mortality, life expectancy at birth, infant mortality, low birth weight, and teen birth rate. It also includes cancer (breast, prostate, lung, and colon), asthma, cholesterol screening, diabetes, heart disease, high blood pressure, stroke and perceptions of health. In 2013 we joined other agencies to compile a report, State of the Pioneer Valley, showing indicators for children and youth, elderly, education, health and safety, economic security, housing, civics, arts and recreation, and the environment. We provided funding for the project, served as expert reviewers for the health and environmental sections, and distributed copies to key leaders. We also reviewed and included in the assessment the Hampshire Prevention Needs Assessment Survey results, showing youth behavior and risk and protective factors. Data include 30 day past use of alcohol, marijuana, and other drugs among 10th and 12th graders, youth binge drinking, and tobacco use. In 2013, we coordinated with other hospitals in the geographic area to survey residents in the region about health care issues including access to care, transportation barriers to care, food and fitness, and other topics. The other hospitals are: Holyoke Medical Center, Wing Memorial Hospital, Mercy Medical Center, Baystate Medical Center, Baystate Mary Lane Hospital, and Baystate Franklin Medical Center. We interviewed key leaders including public health and health care providers. We analyzed the interviews, surveys and indicator reports and identified key themes (health access, transportation, heart disease and cancer rates in Easthampton, mental health continuum of care, Latino health access, and youth substance abuse). We conducted focus groups on the following topics: health access; mental health; and heart disease and cancer rates in Easthampton. We conducted community forums on the same topics. The Healthy Communities Committee, a subcommittee of the Board of Trustees, approved a community benefits plan and budget for FY14 based on the needs assessment results. We have published the health assessment documents and community benefits plan on our website and presented at various community meetings."},{"form_and_line_reference":"Schedule H, Part VI, Line 3","explanation":"Cooley Dickinson Hospital posts signs in the inpatient, clinic, and emergency admissions and registration areas and in business office areas that are customarily used by patients that conspicuously inform patients of the availability of financial assistance programs and the Hospital location at which to apply for such programs. All signs and notices are translated into English and Spanish. The signs notify patients of the availability of financial assistance and of other programs of public assistance. Hampshire HealthConnect (HHC), a Cooley Dickinson Hospital based program, has a mission to help uninsured and underinsured people access health coverage and care. HHC case managers assist uninsured patients to enroll with MassHealth, Health Safety Net and other state healthcare programs. HHC also administers the Hampshire Health Physician Network, a group of local physicians who offer health care to local residents who are low income and cannot qualify for MassHealth or other health insurance. Participating physicians agree to accept reduced fees and are not reimbursed by the Health Safety Net for their services. HHC flyers are distributed to all self pay patients in the emergency department and throughout the Hospital. The Hospital provides an individual notice of the availability of financial assistance programs, including Medical Hardship, to patients expected to incur charges. The Hospital will include a notice about eligible services to Low Income Patients and programs of public assistance in its initial bill and in all written collection actions stating: If you are unable to pay this Hospital bill, you may be eligible for coverage through a financial assistance program. Enrollment in many programs is time sensitive, so please contact our Hampshire HealthConnect Department as soon as possible. To speak with someone in the Hampshire HealthConnect Department, please call (877) 429-0695, Monday through Friday 9:00 am to 5:00 pm. You may also obtain information at the Cashier's Office located in the main entrance of the Hospital."},{"form_and_line_reference":"Schedule H, Part VI, Line 4","explanation":"Cooley Dickinson Hospital CDH serves a population 2013 of 138,934 residents of Hampshire and Franklin counties in the Pioneer Valley region of Massachusetts. Its primary service area (PSA) is comprised of fifteen Hampshire and one Franklin community and secondary service area (SSA) of five Hampshire and six Franklin communities. The PSA includes the following communities from which 50 percent or more of inpatient hospital admissions were to CDH for the three years from fiscal 2009 through fiscal 2011. Amherst, Chesterfield, Cummington, Easthampton, Florence, Goshen, Hadley, Hatfield, Haydenville, Leeds, North Amherst, North Hatfield, Northampton, West Hatfield, Whately, Williamsburg. The following communities, from which 25 percent of more of inpatient hospital admissions were to CDH for the three year period, comprise the SSA. Belchertown does not meet the 25 percent share threshold, but is included because it has the seventh highest volume of discharges. Ashfield, Belchertown, Huntington, Leverett, Plainfield, Shutesbury, South Deerfield, Southampton, Sunderland, West Chesterfield, and Worthington. Population Trends Overall; The PSA population is expected to increase by 0.45 percent by 2018, with growth of 1.23 percent projected for the SSA, according to population data from ESRI Business Information Solutions. This projected stability follows a period of growth, by 4.67 percent, of the SSA population between 2000 and 2010. Factors of interest in planning hospital services and projecting use of hospital services are highlighted below. Aging; The service area is graying, consistent with national trends. *13.2 percent of the PSA population and 14 percent of the SSA was 65 or older in 2013. These rates are consistent with the 2010 rates for Massachusetts 13.8 percent and the United States 13 percent. (By 2018 16 percent of the PSA population and 15.64 percent of the SSA is expected to be 65 and older). *The age cohorts starting at traditional retirement age 65 are growing the fastest. The compound annual growth rate for area residents 65 to 79 from 2013 to 2018 is 4.86 percent in the primary service area and 5.77 percent in the secondary service area. (This means that by 2018, there will be 2,488 more 65 to 79 year olds in the PSA and 1,346 more in the SSA). *The number of residents in the primary and secondary service areas at the upper end of the age spectrum is also expected to grow but at lower rates. The population age 80 and older will grow 1.65 between 2013 and 2018, amounting to 86 more adults 80 or older, with the majority 50, in the SSA by 2018. *Children; The population up to age 14 will decline by 2018, amounting to 552 fewer children (306 from PSA and 246 from SSA). The decline in the population under 24 is not surprising given lower birth rates in our service area. Rates are reported by the Massachusetts Department of Public Health for the state and state defined community health network areas in our region. The Franklin rate of 9.2 and the Hampshire rate of 7.3, the lowest among Massachusetts community health networks in 2010, are below the Massachusetts rate of 11.1. Demographic Profile of Service Area: Income; The communities Cooley Dickinson serves have a broad range of median household incomes. ESRI data shows that the US median household income for 2013 was $54,718, close to the Cooley Dickinson Primary Service Areas $53,797. The Secondary Service Area median household income at $70,496 is closer to the Massachusetts rate of $68,185 than the PSA income. The range of median household incomes in the PSA in 2013 was from $20,000 in the Amherst 01003 zip code to $75,876 in Haydenville the SSA ranged from $42,516 in Sunderland to $83,106 in Southampton. The US census estimates that in 2012 11 percent of Massachusetts residents lived below the poverty level, with rates of 11.9 percent in Hampshire County, 13.5 percent in Northampton 5.8 percent in Easthampton and 30.5 percent in Amherst. The toll of the recession is evident here the 2000 Census reported the percentages of people living below the poverty level as 6.7 in Massachusetts and 9.2 in the nation."},{"form_and_line_reference":"Schedule H, Part VI, Line 4 Cont","explanation":"Race and Ethnicity: The Census Bureau has developed a Diversity Index to compute the differences in diversity among populations. The Diversity Index is expressed as a ratio and reports the percentage of times two randomly selected people would differ by race ethnicity. An areas Diversity Index would be 1.0 when the population is evenly divided into two or more race ethnic groups. According to ESRI, the 2010 Diversity Index for the United States was 0.60 (55.51 in the Northeast). The CDH service area is becoming increasingly diverse. For the Primary Service Area, the Diversity Index was 0.32 in 2013 expected to increase to 0.35 by 2018 (compound annual growth rate of 1.7 percent). While the Secondary Service Area was less diverse in 2013 (0.15) it is expected to diversify more, with a compound annual growth rate of 2.85, by 2018 than the PSA. Using this measure the most diverse place in the service area is the 01003 neighborhood in Amherst which had a 2013 diversity index of 0.44. A rate greater than 0.6 is considered highly diverse. In 2000, 97 percent of PSA residents and 95 percent of SSA residents were white. Those percentages declined to 82 and 92 percent, respectively, by 2013 and are expected to be 80 and 91 by 2018. It is expected there will be 1486 fewer white residents in the PSA and 64 less in the SSA. The next largest group in the PSA was Asian in 2000 (4.62 percent of the population) and Hispanic in the SSA (1.5 percent). By 2013 the percentage of Asian residents increased to 6 in the PSA and is expected to remain at that level for 2018. By 2013 the Hispanic population in the PSA had grown to 6 percent of the population and is expected to increase to nearly 7 percent of the 2018 population, an increase of 798 individuals. In the SSA in 2000, the Hispanic population (at 1.5 percent of residents) was second to white. By 2013 the Hispanic percentage of the SSA population was 2.74 percent and is expected to grow again to 3.18 percent by 2018. The percentages of Black residents are relatively stable 3.27 percent of the PSA population in 2013 projected to be 3.99 percent in 2018 and 1.27 percent and 1.58 percent in the SSA. The net increase is projected to be 868 persons for the Combined Service Area. Diversity changes in the SSA include Hispanic population growth from 2.29 to 2.79 percent representing 194 individuals. More growth is expected in the Asian SSA population, from 1.92 to 2.24 percent, or 126 persons. Cooley Dickinson spent nearly $503,000 on medical interpreter services during the year to assist non English speaking patients. Recession Impact: Despite that the CDH service area income is relatively high, a snapshot of data from the Massachusetts Division of Insurance shows the economic slowdown has affected the insurance coverage that area residents carry. Insurance enrollment by county as of the quarter ending Sept. 30 for 2012 and 2013 indicates a shift from commercial HMOs and the Commonwealth Connector program to Medicaid. Enrollment in commercial HMOs declined by almost 1 percent in Hampshire and by 1.39 percent in Franklin county 2012 and 2013. Enrollment in the Commonwealth Connector program increased over that period by 2.41 percent in Hampshire and by 0.59 percent in Franklin County. Medicaid continues to see growth, up by 9.61 percent in Hampshire County and 8.89 percent in Franklin. Between 2009 and 2013, HMO enrollment decreased by 2.8 percent in Hampshire County and 8.1 percent in Franklin, with Medicaid increasing 28 percent in Hampshire and 37 percent in Franklin and Connector enrollment increasing 25 percent in both counties. Educational Attainment: Cooley Dickinson serves a population with higher levels of educational attainment than Massachusetts and the nation. Fifty percent of PSA residents have a college degree or higher, compared to 38 percent for Massachusetts and 27 percent U.S. Employment: Educational services and health care are the largest employment sectors in Hampshire and Franklin counties. According to Massachusetts Labor and Workforce Development statistics the top 10 employers in Hampshire and Franklin Counties include six educational facilities and four health care facilities. Service Area Health Status: The Cooley Dickinson Community Health Assessment, published on the hospitals website in fall 2013 provides detailed data about health status in Hampshire and Franklin counties. Residents of the Cooley Dickinson Hospital service areas are generally healthier than the population of Massachusetts and the United States. The County Health Rankings reports show that Hampshire County rates in most areas are either on par with best performing communities or similar to state or national rates. Key findings from the health assessment include the need for improved access to care for some vulnerable populations improved access to a continuum of mental health and addiction services; improve access to care through better coordinated transportation systems; and higher than expected rates of cancer and heart disease for one local community. Access to Care: Cooley Dickinson is one of two not for profit hospitals in Hampshire County. The second, Baystate Mary Lane Hospital, is 50 minutes to 1 hour driving time away from Cooley Dickinson. Baystate Health also has facilities about 30 minutes away in northern Franklin Countys Greenfield and south of the Cooley Dickinson service area in Hampden Countys Springfield. The U.S. Health Resources and Services Administration has designated three communities (Chesterfield, Cummington, and Williamsburg) in Cooley Dickinsons primary service area and four (Ashfield, Huntington, Plainfield, and Worthington) in the secondary service area as Medically Underserved Areas (MUAs). A corporate affiliate, CD Practice Associates, employs two primary care physicians and a nurse practitioner in one of the MUAs, Williamsburg, and the hospital provides rehabilitation services in another, Worthington. In addition, US HRSA has designated four secondary service area communities (Ashfield, Leverett, Shutesbury, and Sunderland) as having Medically Underserved Populations (MUPs). Massachusetts health insurance mandate means the percentage of uninsured residents in the service area is low. Nevertheless, the hospital provides a safety net for the uninsured and underinsured through some use of the emergency department for primary care (approximately 10 percent of visits) and actively seeks to enroll patients and residents in coverage through Hampshire Health Connect. The value of Free Care provided in fiscal 2013 was $4,441,000."},{"form_and_line_reference":"Schedule H, Part VI, Line 5","explanation":"Cooley Dickinson Hospitals mission, \"To provide our patients and communities with the best health care in the most appropriate environment\", is carried out by 259 physicians and more than 1,700 employees. Together they cared for 80,000 community members in the year ending Sept. 30 2013. The medical staff of Cooley Dickinson is organized in the public interest. Medical staff privileges are available to all qualified physicians in the community for all of our departments. In addition, the hospital furthered its exempt purpose through partnerships with our affiliated organization, VNA & Hospice of Cooley Dickinson, and community organizations, ranging from Aging Services Access Points and Councils on Aging to long-term care facilities and boards of health. With these partnerships, we worked toward achieving the best health care through projects such as coordinating care for residents with complex medical and psychosocial issues to improve the quality of life of those residents and prevent their avoidable use of health care services. These partnerships are in addition to those created through the processes of assessing community health needs and developing and implementing our community benefits plan. Funds the hospital generates are reinvested in programs or services that meet the healthcare needs of the community, promote improved health, or prevent illness or injury. For example in 2013, the hospital published four issues of its Community Pulse newsletter which provides health prevention and screening information to encourage residents to maintain or improve their health. The hospital also invested funds, to name a few examples, in recruiting physicians and allied health professionals to meet community need; to upgrade mammography equipment; and to invest in electronic medical records to improve coordination and safety of care. Cooley Dickinson focuses on responsiveness to the healthcare needs of our community. When surveyed in 2012 residents report we succeed at that goal rating us 3.72 on a 4.0 scale on how well we respond to needs. Strong community involvement in our organization is also demonstrated by the fact that 60 percent of the 28 voting members of the Board of Trustees in 2013 were independent (the president and three physician trustees are employees of Cooley Dickinson Health Care; five trustees are employees of Partners HealthCare System; two other trustees are contractors). A total of 91 percent of the 23 community trustees live in the hospitals primary or secondary service area the remaining five trustees were appointed by Massachusetts General Hospital and Partners HealthCare System which acquired Cooley Dickinson in July 2013. In addition, 21 other residents were involved in 2013 as volunteers through the Board of Trustees Healthy Communities and Development and Public Relations Committees. A Patient and Family Advisory Council involved 20 additional residents in decisions regarding their non-profit community hospital."},{"form_and_line_reference":"Schedule H, Part VI, Line 6","explanation":"Cooley Dickinson Hospital, Inc. (the Hospital) is an acute care, not for profit 140 bed community hospital located in Northampton Massachusetts and a wholly owned subsidiary of Cooley Dickinson Health Care Corporation (the Corporation). On July 1, 2013, the Corporation and subsidiaries became affiliates of the Massachusetts General Hospital and Partners HealthCare System, Inc. The Hospital provides a broad range of patient services and a number of health related community services, including acute and critical medicine, surgery, psychiatry, and rehabilitation. The goal of the affiliation is to enhance access for residents of the mid Pioneer Valley service area to a broad range of high quality, affordable health care services; lower the cost of care at the Hospital while improving value; and facilitate the deployment of population health management to improve the health of the residents of the Hospitals service area. The Corporation provides fund raising support and maintains donor-restricted funds for the benefit of the Hospital. Other related entities of the Hospital include CD Practice Associates, Inc. (CDPA), a not for profit organization established to own and manage operating groups of physicians; and VNA and Hospice of Cooley Dickinson, Inc. (VNA), a not for profit organization established to provide home health and hospice care services, as well as Partners HealthCare System, Inc. and its affiliates."},{"form_and_line_reference":"Schedule H, Part VI, Line 7","explanation":"Cooley Dickinson Hospital annually files a Community Benefits report with the Office of the Attorney General of the Commonwealth of Massachusetts."}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":22000,"reported_domestic_individual_grants":0,"reported_domestic_org_grants_program_services":22000,"reported_domestic_individual_grants_program_services":0,"total_501c3_and_government_organizations":2,"total_other_organizations":0,"grants":[{"ein":222477843,"irc_section":"501(c)3","cash":15000,"noncash":0,"purpose":"Funding used by Casa Latina to support information and referral services and to establish a database of referrals.","address_line1":"140 Pine Street No 6","city":"Florence","state":"MA","zip":"01062","name":"Casa Latina Inc","address":"140 Pine Street No 6, Florence, MA, 01062"},{"ein":42562893,"irc_section":"501(c03","cash":7000,"purpose":"Grant to the Strategic Planning Initiative for Families and Youth to conduct the Prevention Needs Assessment Survey (PNAS) in partnership with the school systems of Hampshire County. The PNAS measures youth risky behavior and associated risk and protective factors at the level of individual, family, school, and community domains.","address_line1":"97 Hawley Street","city":"Northampton","state":"MA","zip":"01060","name":"Collaborative for Educational Services Inc SPIFFY","address":"97 Hawley Street, Northampton, MA, 01060"}],"total_domestic_grants":22000,"total_domestic_program_services":22000,"detail_org_grants_total":22000,"detail_domestic_grants_total":22000,"supplemental_information":[{"identifier":"SchI_P01_S00_L02","form_and_line_reference":"Schedule I, Part I, Line 2","explanation":"The grant recipients provided a presentation to the Board of Trustees Subcommittee for Healthy Communities. Recipients are also expected to submit a written annual report to the Committee."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"The grant recipients provided a presentation to the Board of Trustees Subcommittee for Healthy Communities. Recipients are also expected to submit a written annual report to the Committee.","form_and_line_reference":"Schedule I, Part I, Line 2"}},"ScheduleF":{"reported_foreign_grants":0,"reported_foreign_grants_program_services":0},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"independent_consultant":true,"compensation_survey_or_study":true,"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":true,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"Craig N Melin","title":"Assist 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