{"success":true,"data":{"_id":41676720,"filings":[{"Organization":{"Hours":[0],"Total Compensation":[0],"Direct compensation":[0],"Other compensation":[0]},"Basic":{"mission":"The mission of north adams regional hospital is to provide exceptional healthcare from the heart.","primary_activities":"The organization provides inpatient services, including internal medicine, surgery, pediatrics, gynecology, obstetrics, and psychiatry along with a critical-care unit for intensive-care and coronary care patients. See schedule o for additional details on program service accomplishments and community benefit.\n\nThe hospital has a broad range of outpatient services, including oncology services, a diagnostic imaging department, clinical laboratory services, cardiac testing, rehabilitation center, speech therapy, endoscopy center, and specialty clinics. See schedule o for additional details on program service accomplishments and community benefit.\n\nThe organization operates an emergency room, providing 24-hour service to nearly 21,000 patients each year. See schedule o for additional details on program service accomplishments and community benefit.\n\nThe mission of northern berkshire healthcare is to provide exceptional healthcare from the heart. Northern berkshire healthcare includes north adams regional hospital, the visiting nurse association & hospice of northern berkshire, sweet brook transitional care & living centers, sweetwood continuing care retirement community, reach for community health and the nbh physicians group. A full service community hospital, narh includes 24 hour emergency care, diagnostic imaging, laboratory, birthing center, ob, surgery, psychiatry, physical rehabilitation, inpatient, and outpatient care. It is the primary hospital for over 40,000 residents of northern berkshire county. Reach is the health education and health promotion arm of northern berkshire healthcare and oversees the community benefits program for north adams regional hospital. The mission of reach is to improve the health of the northern berkshire community through education, outreach, advocacy and treatment, in partnership with community members and organizations. Reach is now a department of narh and they continue to have the responsibility of overseeing community health benefits and needs.\n\nNorth adams regional hospital (narh) is a non-profit, acute-care, community hospital licensed by the massachusetts department of health to provide primary-care services, specialty-physician services, diagnostic and treatment services, and wound care services. Narh is a designated medicare-dependent hospital. In addition, the adams and north adams are designated as a low income primary care health professional shortage area for adult primary care, obstetrics and dentistry and maintains a hpsa score of 13. The hospital provides a range of inpatient and outpatient services, including the major specialties of internal medicine, surgery, pediatrics, gynecology, obstetrics, and psychiatry. In addition, it has a critical-care unit, which cares for both intensive-care patients and coronary-care patients. Medical/surgical services: the hospital has one medical/surgical floor with 25 beds including 5 beds for pediatric patients. There are 14 dual occupancy patient rooms and 3 private rooms. This floor was most recently renovated in 2009. Critical care & telemetry unit: this unit can monitor 8 ccu and 4 telemetry patients. The unit was fully renovated in 2006 and is licensed for 13 beds. Five beds are non-monitored and used for telemetry or step-down beds and 8 are critical care beds. Telemetry patients require cardiac monitoring but do not required critical care nursing. Narh does not care for trauma patients. These patients are referred out to tertiary care facilities in either albany or springfield, massachusetts. Pediatrics: the hospital's pediatric unit is located on the medical/surgical floor of the hospital. Obstetrical services: the hospital's maternity ward offers family-centered maternity care, which is a flexible program designed to meet the needs of new parents and infants. The hospital currently has five board certified obstetricians/gynecologists on staff. The entire suite was renovated in 2007. Improvements included the enlargement of the individual patient rooms and the addition of private bathrooms and other amenities. Renovations included five private post-partum rooms, a modernized nursery, three labor and delivery rooms, a new nurses' station and a new fathers' and family waiting area. Surgery department: the hospital maintains three full-service operating rooms (with a fourth used to improve case turnaround and for future expansion) and sixteen pre- and post-operative ambulatory-care operating rooms with nine recovery beds for use in the post-surgical stabilization of patients. The hospital has 32 board certified and 4 board eligible surgeons on staff, representing major surgical specialties such as general surgery, urology, gynecology and orthopedic surgery. The ambulatory surgery department was completed renovated in 2007 and contains three fully-equipped operating rooms, two fully-equipped endoscopy suites, private examination, consultation and recovery rooms, and a new waiting lounge. Psychiatric services: the hospital's psychiatric unit, greylock pavilion (\"greylock\"), commenced operation in 1989. It is a locked unit with 20 beds. Greylock treats a range of patients from age 16 and up and operates a unit specializing in the treatment of patients dually diagnosed with mental illness and substance abuse. Eileen a. Barrett oncology center: in 1994, the hospital opened the eileen a. Barrett oncology center, which was financed by private contributions, to provide treatment of and services to cancer patients. Treatment available at the hospital for oncology care includes chemotherapy and surgery. Outpatient chemotherapy is available at the hospital through collaboration with northern berkshire hematology and oncology. The hospital has five board certified oncologists and referral arrangements with various hospital and hospice programs. Diagnostic imaging services: the hospital provides a range of diagnostic and therapeutic services to both inpatients and outpatients, including 64-slide ct scan, digital echocardiography, nuclear medicine, digital x-ray, digital ultrasound, digital mammography, mri, stereotactic breast biopsy and digital bone densitometry. To meet the growing demand for diagnostic imaging services, the hospital added a picture archiving and communications systems (pacs) in 2007. Mammography, echocardiology, ultrasound and bone densitometry were upgraded to digital technology in 2009 and the mri is scheduled to be replaced with a fixed unit, large bore open magnet in the summer of 2010. The hospital has 3 board certified radiologists on staff. Clinical laboratory: the laboratory offers both anatomical and clinical pathology programs and there are 3 board certified pathologists on staff. The laboratory performs 400,000 tests each year. Pharmacy: the hospital pharmacy maintains an inpatient license only and serves an employee benefit function by filling prescription requests for employees. Pharmacy services to the bedside are delivered via omnicell medication cabinets on each of the medical floors and utilization of the meditech pharmacy module. Pharmacy services are available sixteen hours per day and night hours are covered by cardinal health services via remote access to meditech. Rehabilitation programs: the hospital has a long history as an outpatient rehabilitation provider. The hospital's outpatient rehabilitation center includes a full range of speech therapy, occupational therapy, and physical therapy. The hospital maintains a community rehabilitation service in adams, massachusetts. Endoscopy center: the endoscopy unit of the hospital houses one of the fastest growing services offered by the hospital. The endoscopy suite was renovated as part of the organization's 2004-7 renovation project and full high-definition endoscopy imaging was added in 2009. Outpatient services: the hospital has a broad range of outpatient services. These services include the emergency department; oncology services; a diagnostic imaging department, including mri, 64-slice ct scan, digital x-ray, digital mammography, digital ultrasound, digital bone density; nuclear medicine and a pacs system; clinical laboratory services; cardiac testing; rehabilitation center for physical occupational, and speech therapy; endoscopy center; and specialty clinics. Emergency services: the hospital's emergency department is an active component of the hospital. The hospital's emergency department provides 24-hour service to nearly 21,0000 patients each year. All physicians working in the emergency department are certified in advanced cardiac life support and advanced trauma life support. All nurses working in the emergency department are certified in advanced cardiac life support and pediatric emergency nursing. The emergency department underwent a significant renovation and expansion in 2007. The improvements included an expansion of the service area by 50% with additional exam rooms and the addition of radiology services in the department to expedite diagnostic services. These renovations created an emergency department that contains seventeen rooms, including four new cardiac observation rooms, five acute- and sub-acute examination areas, two private cardiac examination rooms, a new gynecological examination area and a private observation room.","year":2009,"name":"NORTH ADAMS REGIONAL HOSPITAL","phone":"4136643701","website":"WWW.NBHEALTH.ORG","type":"990","principal_officer":"RICHARD PALMISANO","year_formation":1884,"state_legal_domicile":"MA","total_volunteers":122,"tax_period_begin":"2009-10-01T00:00:00","tax_period_end":"2010-09-30T00:00:00","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247, USA","city":"NORTH ADAMS","state":"MA","country":"USA","zip_code":"01247"},"Governance":{"501c determination":true,"Number of voting members":17,"Number of independent voting members":15,"Number of employees total":537,"Total Gross UBI":133862,"Net unrelated business taxable income":33871,"Number of employees":537,"Prohibited tax shelter transactions":false,"Taxable party notification":false,"Funds to pay premiums":false,"Premiums Paid":false,"Family or business relationship":false,"Delegation of management duties":true,"Conflict of interest policy":true,"Whistle blower policy":true,"Compensation process for CEO":true,"Compensation process for other employees":true,"Changes to organizing documents":false,"Material diversion or misuse":false,"Members or stockholders":true,"Election of board members":true,"Decisions subject to approval":true,"Minutes of governing body":true,"Local chapters":false,"Form 990 provided to governing body":true,"Document retention policy":true,"Investment in joint venture":false,"Independent audit financial statements":false,"Consolidated audit financial statements":false,"Accountant compile or review":false,"Financial statements audited by independent accountant":false,"Federal grant audit required":false,"Political activities":false,"Donor advised funds":false,"Conservation easements":false,"Collections of art":false,"School":false,"Hospital":true,"Foreign activities":false,"Foreign office":false,"Gaming":false,"Fundraising activities":false,"Professional fundraising":false,"Loan to officer or DQP":false,"Grant to related person":false,"Business relationship through family member":false,"Business relationship with organization":false,"Transfers to exempt non-charitable organization":false},"Revenues":{"value":60827749,"Contributions":{"value":481225,"Other contributions":360362,"Grant revenue":120863},"Program revenue":{"value":59843216,"Total revenue":{"value":59843216,"VARIOUS":59843216},"Unrelated business revenue":133862},"Investment income":{"value":347558,"Investment income total":99666,"Net investment gain":247892,"Income from invest bond proceeds":0},"Other revenues":{"value":155750,"Other total":0,"Royalties revenue":0,"Net rental income":155750,"Net income from fundraising events":0,"Net income from gaming":0,"Net income":0}},"Expenses":{"value":65417267,"Grant expense":{"value":0,"Grants to domestic orgs":0,"Grants to domestic individuals":0,"Foreign grants":0},"Total professional fundraising expense":{"value":0,"Fundraising professional":0},"Benefits paid to members":{"value":0,"Benefits paid to members Total":0},"Salaries":{"value":34264604,"Current officers":1020513,"Disqualified persons":0,"Other salaries and wages":24432610,"Pension plan contributions":3187672,"Other employee benefits":3656913,"Payroll taxes":1966896},"Other expenses":{"value":31152663,"Management services":3480090,"Legal":997406,"Accounting":386699,"Lobbying services":0,"Investment management fees":18254,"Other services":9904417,"Advertising":89361,"Office expenses":5718276,"Information technology":1250,"Royalties":0,"Occupancy":996962,"Travel":46617,"Conferences and meetings":86569,"Interest":2476971,"Payments to affiliates":0,"Depreciation and depletion":2933272,"Insurance":632347,"Travel entertainment public officials":0,"Itemized Expenses":{"value":3384172,"VARIOUS":3384172}}},"Assets":{"value":67265935,"Non-interest bearing cash":715826,"Savings and temp cash investments":5556882,"Pledges and grants receivable":5000,"Accounts receivable":5533666,"Inventories for sale or use":1288171,"Prepaid expenses deferred charges":1133175,"Land, building, equipment":33494647,"Investments publicly traded":1954657,"Other assets":17583911},"Liabilities":{"value":67369259,"Accounts payable, accrued":30054486,"Deferred, revenue":631274,"Tax exempt bond liabilities":28731896,"Secured mortgages and notes payable":6491554,"Unsecured notes loans payable":384262,"Other liabilities":1075787},"Fund balance":{"value":-103324},"Form990Details":{"program_service_accomplishments":[{"description":"THE ORGANIZATION PROVIDES INPATIENT SERVICES, INCLUDING INTERNAL MEDICINE, SURGERY, PEDIATRICS, GYNECOLOGY, OBSTETRICS, AND PSYCHIATRY ALONG WITH A CRITICAL-CARE UNIT FOR INTENSIVE-CARE AND CORONARY CARE PATIENTS. SEE SCHEDULE O FOR ADDITIONAL DETAILS ON PROGRAM SERVICE ACCOMPLISHMENTS AND COMMUNITY BENEFIT.","expense":26030200,"revenue":24287277},{"description":"THE HOSPITAL HAS A BROAD RANGE OF OUTPATIENT SERVICES, INCLUDING ONCOLOGY SERVICES, A DIAGNOSTIC IMAGING DEPARTMENT, CLINICAL LABORATORY SERVICES, CARDIAC TESTING, REHABILITATION CENTER, SPEECH THERAPY, ENDOSCOPY CENTER, AND SPECIALTY CLINICS. SEE SCHEDULE O FOR ADDITIONAL DETAILS ON PROGRAM SERVICE ACCOMPLISHMENTS AND COMMUNITY BENEFIT.","expense":14662419,"revenue":22882449},{"description":"THE ORGANIZATION OPERATES AN EMERGENCY ROOM, PROVIDING 24-HOUR SERVICE TO NEARLY 21,000 PATIENTS EACH YEAR. SEE SCHEDULE O FOR ADDITIONAL DETAILS ON PROGRAM SERVICE ACCOMPLISHMENTS AND COMMUNITY BENEFIT.","expense":8566342,"revenue":12539628}],"program_service_revenue_detail":[{"business_code":"900099","description":"PATIENT SERVICE REVENUE","total_revenue":58137847},{"business_code":"900099","description":"OTHER REVENUE","total_revenue":1571507},{"business_code":"811000","description":"MAINTENANCE INCOME","total_revenue":39210},{"business_code":"812900","description":"HOUSEKEEPING INCOME","total_revenue":94652}],"functional_expense_allocations":{"current_officers_directors":{"program_services":362752,"management_and_general":657761,"total":1020513},"disqualified_persons":{"total":0},"other_salaries_and_wages":{"program_services":20076865,"management_and_general":4355745,"total":24432610},"pension_plan_contributions":{"program_services":2569522,"management_and_general":618150,"total":3187672},"other_employee_benefits":{"program_services":2959793,"management_and_general":697120,"total":3656913},"payroll_taxes":{"program_services":1581480,"management_and_general":385416,"total":1966896},"management_fees":{"management_and_general":3480090,"total":3480090},"legal_fees":{"management_and_general":997406,"total":997406},"accounting_fees":{"management_and_general":386699,"total":386699},"lobbying_fees":{"total":0},"professional_fundraising_fees":{"total":0},"investment_management_fees":{"management_and_general":18254,"total":18254},"other_service_fees":{"program_services":7963634,"management_and_general":1940783,"total":9904417},"advertising":{"program_services":71851,"management_and_general":17510,"total":89361},"office_expenses":{"program_services":4597774,"management_and_general":1120502,"total":5718276},"information_technology":{"program_services":1005,"management_and_general":245,"total":1250},"royalties":{"total":0},"occupancy":{"program_services":801606,"management_and_general":195356,"total":996962},"travel":{"program_services":37482,"management_and_general":9135,"total":46617},"conferences_meetings":{"program_services":69606,"management_and_general":16963,"total":86569},"interest":{"program_services":1991605,"management_and_general":485366,"total":2476971},"payments_to_affiliates":{"total":0},"depreciation_depletion":{"program_services":2358494,"management_and_general":574778,"total":2933272},"insurance":{"program_services":508438,"management_and_general":123909,"total":632347}},"tax_and_disclosure_flags":{"activities_conducted_through_partnership":false,"foreign_financial_account":false,"backup_withholding_compliance":true,"employment_tax_returns_filed":true,"lobbying_activities":true,"deductible_non_cash_contributions":false,"deductible_contributions_of_art":false,"method_of_accounting_accrual":true},"principal_officer_detail":{"person_name":"RICHARD PALMISANO","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247"},"audit_financial_statement_detail":{"accountant_compile_or_review":false,"federal_grant_audit_required":false},"related_party_due_diligence":{"officer_entity_with_business_relationship":false,"officer_mailing_address":false,"related_entity":true,"related_org_controlled_entity":false,"compensation_from_other_sources":false,"excess_benefit_transaction":false,"annual_disclosure_covered_persons":true},"grant_due_diligence":{"grants_to_organizations":false,"grants_to_individuals":false,"more_than_5000_to_organizations":false,"more_than_5000_to_individuals":false},"books_are_in_care_of":{"person_name":"CHRISTOPHER HICKEY","phone":"4136645507","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247"},"contractor_compensation":[{"person_name":"MOLARI INC","compensation":591183,"services_description":"TEMP EMPLOYMENT SVCS","name":"MOLARI INC"},{"person_name":"SCHWARTZ HANNUM PC","compensation":554174,"services_description":"LEGAL SERVICES","name":"SCHWARTZ HANNUM PC"},{"person_name":"SPECIALTY LABORATORIES","compensation":523294,"services_description":"LABORATORY SERVICES","name":"SPECIALTY LABORATORIES"},{"person_name":"LINC HEALTH INC","compensation":384165,"services_description":"BIO MED SERVICES","name":"LINC HEALTH INC"},{"person_name":"SODEXHO USA","compensation":367196,"services_description":"MGT/CONSULT. 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A PORTION OF THESE DUES, 24.42% AND 24.94%, RESPECTIVELY, IS ATTRIBUTABLE TO LOBBYING EXPENSES, FOR A TOTAL AMOUNT OF $15,454."}]},"ScheduleD":{"endowment_funds":{"current_year":{"beginning_year_balance":863063,"contributions":50000,"end_year_balance":913063},"current_year_minus1":{"beginning_year_balance":843063,"contributions":20000,"end_year_balance":863063},"permanent_endowment_eoy_percentage":1.0,"held_by_unrelated_organizations":true,"held_by_related_organizations":false},"land_buildings_equipment":{"land":{"other_cost_or_other_basis":24830,"book_value":24830},"buildings":{"other_cost_or_other_basis":45000005,"book_value":22363311,"depreciation":22636694},"equipment":{"other_cost_or_other_basis":31945407,"book_value":8359518,"depreciation":23585889},"other_land_buildings":{"other_cost_or_other_basis":3683632,"book_value":2746988,"depreciation":936644},"total_book_value":33494647},"other_assets":{"assets":[{"description":"SECURITY DEPOSITS","book_value":10000},{"description":"LIFE INSURANCE CSV","book_value":89811},{"description":"OTHER ASSETS","book_value":6451},{"description":"BENEFICIAL INT IN TRUSTS","book_value":617950},{"description":"DUE FROM RELATED PARTY","book_value":16644070},{"description":"OTHER RECEIVABLES","book_value":215629}],"total_book_value":17583911},"other_liabilities":{"federal_income_tax_liability":0,"liabilities":[{"description":"EST DUE TO 3RD PARTIES","amount":748595},{"description":"ASSET RETIREMENT OBLIGATION","amount":327192}],"total_liability":1075787},"supplemental_information":[{"identifier":"ENDOWMENT PURPOSE","form_and_line_reference":"SCHEDULE D, PART V, LINE 4","explanation":"ENDOWMENT FUNDS ARE RESTRICTED, BUT THE INCOME GENERATED IS AVAILABLE FOR USE BY THE ORGANIZATION. IT IS USUALLY UNRESTRICTED WITH A SPENDING CAP ON THE AMOUNT OF INCOME. THE EARNINGS MAY BE USED FOR A NUMBER OF USES INCLUDING DAY TO DAY OPERATIONS AND CAPITAL EXPENDITURES."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_400":true,"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":512320,"bad_debt_expense_attributable_to_financial_assistance":65577,"reimbursed_by_medicare":18039603,"cost_of_care_reimbursed_by_medicare":21680406,"medicare_surplus_or_shortfall":-3640803,"costing_methodology_other":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":1469885,"direct_offsetting_revenue":630664,"net_community_benefit_expense":839221,"total_expense_percentage":0.0128},"unreimbursed_medicaid":{"total_community_benefit_expense":9295782,"direct_offsetting_revenue":9114933,"net_community_benefit_expense":180849,"total_expense_percentage":0.0028},"unreimbursed_costs":{"total_community_benefit_expense":2379839,"direct_offsetting_revenue":1366323,"net_community_benefit_expense":1013516,"total_expense_percentage":0.0155},"total_financial_assistance":{"total_community_benefit_expense":13145506,"direct_offsetting_revenue":11111920,"net_community_benefit_expense":2033586,"total_expense_percentage":0.0311},"community_health_services":{"total_community_benefit_expense":191994,"net_community_benefit_expense":191994,"total_expense_percentage":0.0029},"subsidized_health_services":{"total_community_benefit_expense":8070975,"direct_offsetting_revenue":4765618,"net_community_benefit_expense":3305357,"total_expense_percentage":0.0282},"cash_and_inkind_contributions":{"total_community_benefit_expense":7803,"net_community_benefit_expense":7803,"total_expense_percentage":0.0001},"total_other_benefits":{"total_community_benefit_expense":8270772,"direct_offsetting_revenue":4765618,"net_community_benefit_expense":3505154,"total_expense_percentage":0.0312},"total_community_benefits":{"total_community_benefit_expense":21416278,"direct_offsetting_revenue":15877538,"net_community_benefit_expense":5538740,"total_expense_percentage":0.0623}},"hospital_facilities":[{"business_name_line1":"NORTH ADAMS REGIONAL HOSPITAL","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"NORTH ADAMS REGIONAL HOSPITAL","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"},{"business_name_line1":"ADAMS REHABILITATION CENTER","address_line1":"1 COMMERCIAL STREET","city":"ADAMS","state":"MA","zip":"01220","other_description":"PHYSICAL THERAPY","name":"ADAMS REHABILITATION CENTER","address":"1 COMMERCIAL STREET, ADAMS, MA, 01220"}],"part_vi_explanations":{"affiliated_health_care_system":"NORTH ADAMS REGIONAL HOSPITAL IS A SUBSIDIARY OF NORTHERN BERKSHIRE HEALTHCARE, LOCATED IN BERKSHIRE COUNTY IN THE NORTHWESTERN CORNER OF MASSACHUSETTS. THE HEALTH SYSTEM, IN ADDITION TO THE HOSPITAL, INCLUDES THE VISITING NURSE ASSOCIATION AND HOSPICE OF NORTHERN BERKSHIRE. REACH FOR COMMUNITY HEALTH EXECUTES THE MAJORITY OF COMMUNITY BENEFITS PROGRAMS AND RESPONDS TO THE NEEDS OF THE COMMUNITY WITH ITS DIRECT HEALTH-RELATED PROGRAMMING, MUCH OF WHICH IS GRANT FUNDED. AS A DEPARTMENT OF NORTH ADAMS REGIONAL HOSPITAL, REACH HAS FINANCIAL SUPPORT FOR ITS CORE ADMINISTRATIVE FUNCTIONS; THIS SUPPORT ALLOWS REACH TO MAXIMIZE ITS CAPACITY TO DEVELOP, IMPLEMENT, AND EVALUATE THE NUMEROUS PROGRAMS AND INTERVENTIONS THAT IT PROVIDES IN THE COMMUNITY. THE REACH COMMUNITY BENEFITS COMMITTEE, IS A STANDING COMMITTEE OF THE NBH BOARD OF TRUSTEES AND HAS DIRECT OVERSIGHT OF THE NARH COMMUNITY BENEFIT PLAN AND SUBSEQUENT ACTIVITY. REACH FOR COMMUNITY HEALTH IS MANAGED BY A DIRECTOR WITH OVERSIGHT BY THE SENIOR EXECUTIVE GROUP OF NORTHERN BERKSHIRE HEALTHCARE.","bad_debt_footnote":"THERE WAS NOT A FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS AS NO FORMAL REPORT WAS PREPARED. HOWEVER, THE COSTING METHODOLOGY IS THE HOSPITAL'S COST TO CHARGE RELATIONSHIP APPLIED TO THE BAD DEBT PROVISION WHICH APPEARS ON THE INCOME STATEMENT. THIS SHOULD BE CONSIDERED A COMMUNITY BENEFIT SINCE SERVICE IS PROVIDED REGARDLESS OF ABILITY TO PAY AND FAILURE TO PAY DOES NOT RESULT IN ANY ACTION OTHER THAN SENDING STATEMENTS AND USING A COLLECTIONS AGENCY, TO ATTEMPT TO COLLECT THE PAYMENT. THE HOSPITAL DOES NOT PUT LIENS ON PATIENT ASSETS, REPORT NON PAYMENT TO CREDIT REPORTING AGENCIES, AND DOES NOT CHARGE INTEREST ON PATIENT DEBT. THE HOSPITAL WILL NOT REFUSE TO TREAT A PATIENT THAT CURRENTLY IS IN A BAD DEBT STATUS REGARDING PREVIOUS SERVICES AT THE HOSPITAL.","community_building_activities":"THE NORTHERN BERKSHIRE COMMUNITY IS KNOWN FOR ITS COLLABORATIVE APPROACH IN WORKING ON VARIOUS PROBLEMS. TO SERVE OUR TARGET POPULATION, REACH AND NORTH ADAMS REGIONAL HOSPITAL OFTEN COLLABORATE WITH LOCAL ENTITIES, INCLUDING THE FOLLOWING: NORTHERN BERKSHIRE COMMUNITY COALITION; ECU HEALTH CARE; CHILDCARE OF THE BERKSHIRES; BERKSHIRE COMMUNITY ACTION COUNCIL; WILLIAMSTOWN MEDICAL ASSOCIATES AND OTHER MEDICAL GROUPS; BERKSHIRE NURSING FAMILIES; THE HORIZON ADVISORY BOARD AND ELDER SERVICES OF BERKSHIRE COUNTY; AREA COUNCILS ON AGING; NORTHERN BERKSHIRE UNITED WAY; TARGET: HUNGER; WILLIAMS COLLEGE; MASSACHUSETTS COLLEGE OF LIBERAL ARTS (MCLA); THE NORTH ADAMS PUBLIC SCHOOLS, ADAMS AND CHESHIRE REGIONAL SCHOOL DISTRICT, MASS MOCA AND THE BERKSHIRE FOOD PROJECT, AMONG OTHERS.","community_information":"THE PRIMARY SERVICE AREA (PSA) FOR NORTH ADAMS REGIONAL HOSPITAL (NARH) IS COMPRISED OF THE FOLLOWING TOWNS: NORTH ADAMS, ADAMS, FLORIDA, CLARKSBURG, AND WILLIAMSTOWN. COMPARED TO MASSACHUSETTS, NORTH ADAMS REGIONAL HOSPITAL SERVES A POORER AND LESS EDUCATED POPULATION OF RESIDENTS. THIS IS IMPORTANT BECAUSE RESEARCH HAS DEMONSTRATED THAT SOCIOECONOMIC STATUS AFFECTS HEALTH. ACCORDING TO THE U.S. CENSUS IN 2000, 726 FAMILIES IN THE PSA LIVED BELOW THE FEDERAL POVERTY LEVEL. OF THOSE, 603 INCLUDED RELATED CHILDREN UNDER 18 AND 298 CHILDREN UNDER FIVE. THE RATES OF ELDERS AGE 65 PLUS WHO LIVE BELOW THE POVERTY LEVEL ALSO EXCEED STATE RATES. RESIDENTS WITH LESS THAN A NINTH GRADE EDUCATION EXCEED THAT FOR THE STATE IN ALL BUT WILLIAMSTOWN, AND EVEN THERE THE PERCENTAGE IS ONLY 5/10THS LESS THAN THE STATE RATE. IN ADAMS AND NORTH ADAMS, THE PERCENTAGE OF PEOPLE WITHOUT A HIGH SCHOOL DIPLOMA EXCEEDS THE STATE RATE BY 5.9 PERCENTAGE POINTS AND 6.7 PERCENTAGE POINTS, RESPECTIVELY. BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA (2002-2007) INDICATES THE RATE OF INSURED PEOPLE IN THE BERKSHIRES COMMUNITY HEALTH NETWORK ASSOCIATION (CHNA) IS BELOW THE STATE FOR MEN BUT ABOVE THE STATE RATE OVERALL AND FOR WOMEN. WHILE 13 PERCENT OF MASSACHUSETTS RESIDENTS 18-34 REPORTED BEING WITHOUT INSURANCE, THE RATE IS 19 PERCENT IN THE BERKSHIRES. THE RATE OF UNINSURED PEOPLE 55-64 IS 25 PERCENT HIGHER IN THE BERKSHIRES THAN IN THE STATE, AND TWO PERCENT OF PEOPLE 65+ IN THE BERKSHIRES REPORT BEING UNINSURED. FURTHER, ACCORDING TO BRFSS DATA, THE PERCENTAGE OF RESPONDENTS REPORTING THEY WERE UNABLE TO SEE A DOCTOR IN THE PAST YEAR (2003-2007) DUE TO COST WAS HIGHER OVERALL AND FOR WOMEN THAN THE STATE AND THE PERCENTAGE OF RESPONDENTS IN THE BERKSHIRES AGES 45-54 WHO SAID THEY COULD NOT SEE A DOCTOR BECAUSE OF COST WAS 49 PERCENT HIGHER THAN THE STATE RATE. THE ELDER POPULATION IN NORTHERN BERKSHIRE COMPRISES A MUCH HIGHER PERCENTAGE OF THE POPULATION AS A WHOLE THAN IT DOES FOR THE STATE OF MASSACHUSETTS. THE PERCENTAGE OF THE ELDERLY PEOPLE 85 AND OLDER, IS MORE THAN 1% HIGHER IN NORTHERN BERKSHIRE. THE PERCENTAGES OF THE YOUNGER ELDERS ARE HIGHER IN NORTHERN BERKSHIRE AS WELL.","debt_collection_policy":"PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS. THE HOSPITAL MAY SEEK COLLECTION ACTION FOR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY THE FINANCIAL ASSISTANCE PROGRAM THE PATIENT IS ENROLLED IN. THE HOSPITAL WILL NOT UNDERTAKE COLLECTION ACTION AGAINST ANY INDIVIDUAL THAT HAS BEEN APPROVED FOR MEDICAL HARDSHIP. THE HOSPITAL WILL NOT GARNISH LOW INCOME PATIENTS OR THEIR GUARANTOR'S WAGES OR EXECUTE LIENS. THE HOSPITALS INTERNAL FINANCIAL ASSISTANCE PROGRAM ALLOWS THE HOSPITAL TO CEASE ANY COLLECTION OR BILLING ACTIONS AGAINST A PATIENT WHO IS UNABLE TO PAY THE HOSPITAL BILL AT ANY TIME DURING THE BILLING PROCESS.","needs_assessment":"REACH FOR COMMUNITY HEALTH, A DEPARTMENT OF NORTH ADAMS REGIONAL HOSPITAL, HAS OVERSIGHT RESPONSIBILITY FOR THE ORGANIZATION'S COMMUNITY BENEFITS PROGRAM. THE MISSION OF REACH IS TO IMPROVE THE HEALTH OF THE NORTHERN BERKSHIRE COMMUNITY THROUGH EDUCATION, OUTREACH, ADVOCACY, AND TREATMENT, IN PARTNERSHIP WITH COMMUNITY MEMBERS AND ORGANIZATIONS. REACH EXECUTES THE MAJORITY OF COMMUNITY BENEFITS PROGRAMS AND RESPONDS TO THE NEEDS OF THE COMMUNITY WITH ITS DIRECT HEALTH-RELATED PROGRAMMING, MUCH OF WHICH IS GRANT FUNDED. AS A DEPARTMENT OF NORTH ADAMS REGIONAL HOSPITAL, REACH HAS FINANCIAL SUPPORT FOR ITS CORE ADMINISTRATIVE FUNCTIONS; THIS SUPPORT ALLOWS REACH TO MAXIMIZE ITS CAPACITY TO DEVELOP, IMPLEMENT, AND EVALUATE THE NUMEROUS PROGRAMS AND INTERVENTIONS THAT IT PROVIDES IN THE COMMUNITY. A COMMUNITY NEEDS ASSESSMENT WAS CONDUCTED BY THE DIRECTOR OF REACH AND THE VP OF EXTERNAL AFFAIRS OF NORTH ADAMS REGIONAL HOSPITAL IN SEPTEMBER 2009 THAT INCLUDED DATA GATHERING AS WELL AS COMMUNITY SURVEYS. INFORMATION WAS COLLECTED FROM NARH DISCHARGE DATA, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH (MASSCHIP DATA AND BUREAU OF ENVIRONMENTAL HEALTH DATA), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA , U.S. CENSUS 2000 AND NORTHERN BERKSHIRE COMMUNITY COALITION 2009 PREVENTION NEEDS ASSESSMENT SURVEY, WHICH FOCUSES ON YOUTH. THE PROCESS INCLUDED A SURVEY THAT ASKED RESPONDENTS TO RATE DISEASES/HEALTH RISKS BY MOST CONCERN AND RATE CONTRIBUTING FACTORS TO HEALTH BY MOST CONCERN (E.G.: PCP AVAILABILITY). RESPONDENT GROUPS INCLUDED 13 AREA PHYSICIANS (15.6% RESPONSE RATE), 78 COMMUNITY ORGANIZATIONS, AND 1235 NBH CORPORATORS (30% RESPONSE RATE); THEY WERE SURVEYED USING AN INTERNET-BASED SURVEY. TWO GROUPS WERE SURVEYED THROUGH THE NORTHERN BERKSHIRE COMMUNITY COALITION. AT A COMMUNITY PLANNING MEETING THERE WERE 68 RESPONDENTS AND THE COALITION COMMUNITY OUTREACH WORKERS SURVEYED 69 AREA RESIDENTS. BASED UPON ALL OF THE COLLECTED DATA, THE COMMUNITY BENEFITS COMMITTEE IDENTIFIED THE FOLLOWING TARGET POPULATIONS: LOWER INCOME RESIDENTS, YOUTH, 18-34 YEAR OLD, AND ELDERS. THE COMMITTEE SELECTED THE FOLLOWING COMMUNITY BENEFITS PRIORITIES: HEALTHY EATING, PHYSICAL ACTIVITY, EMOTIONAL WELL-BEING & SUPPORT, AND SAFE CHOICES, ALL OF WHICH FALL UNDER THE UMBRELLA OF HEALTHY LIFESTYLES. REACH TARGETS ALL RESIDENTS OF NORTHERN BERKSHIRE COUNTY, WITH A PARTICULAR EMPHASIS ON THE UNINSURED AND UNDERINSURED. PRIMARY PREVENTION AND EARLY DETECTION ARE AT THE CORE OF REACH'S COMMUNITY INITIATIVES. EACH OF REACH'S NUMEROUS PROGRAMS IS BASED ON ASSESSMENT OF COMMUNITY NEED AND INCLUDES SPECIFIC PROCESS AND OUTCOME MEASURES.","other_information":"IN ADDITION TO THE GOVERNING BOARD, THE NBH BOARD OF TRUSTEES, A COMMUNITY BOARD, NORTHERN BERKSHIRE HEALTHCARE CORPORATORS, SERVES AS LIAISON TO THE NORTHERN BERKSHIRE COMMUNITY AND HAS THE AUTHORITY TO APPROVE NOMINATIONS TO THE BOARD OF CORPORATORS AND THE NBH BOARD OF TRUSTEES, AND MAKE ADJUSTMENTS IN THE BYLAWS GOVERNING NBH. CORPORATORS ARE ELECTED FROM THE COMMUNITIES SERVED BY NBH AND ITS AFFILIATES.","patient_education_assistance":"IN NORTH BERKSHIRE COUNTY, ECU-HEALTH CARE, WHICH IS THE AREA'S ENROLLMENT SITE FOR ALL PUBLIC HEALTH PROGRAMS, PROVIDES FINANCIAL COUNSELING SERVICES FOR THE PATIENTS OF NORTH ADAMS REGIONAL HOSPITAL. ALL SELF-PAY PATIENTS, AT TIME OF SERVICE, ARE GIVEN INFORMATION ABOUT ECU-HEALTH CARE'S SERVICES AND ECU-HEALTH CARE CONTACTS PATIENTS IMMEDIATELY. ECU-HEALTH CARE'S PROGRAM SERVICES INCLUDE: o PROVIDING ONE-TO-ONE ENROLLMENT ASSISTANCE FOR ALL PUBLIC HEALTH PROGRAMS. THIS INCLUDES CASE-MANAGEMENT TO INSURE THAT PATIENTS COMPLETE APPLICATION PROCESSES. o CONDUCTING COMMUNITY OUTREACH AND MARKETING CAMPAIGNS FOR MASSHEALTH, COMMONWEALTH CARE, THE MEDICAL SECURITY PLAN, COMMONWEALTH CHOICE, PRESCRIPTION ADVANTAGE, AND ALL OTHER MEDICARE ASSISTANCE PROGRAMS. o WORKING CLOSELY WITH AREA PHYSICIAN GROUPS TO ENSURE THAT APPLICANTS HAVE PRIMARY CARE PROVIDERS. ECU-HEALTH CARE ALSO MAINTAINS A VOLUNTARY PHYSICIAN PROGRAM FOR THOSE NOT ELIGIBLE FOR PUBLIC HEALTH COVERAGE. IN ADDITION, WE HAVE AN AGREEMENT WITH A NUMBER OF LOCAL DENTISTS WHO HAVE AGREED TO PROVIDE SERVICES AT A REDUCED FEE TO LOWER INCOME RESIDENTS WITHOUT DENTAL COVERAGE.","reports_filed_with_states":"MA","shortfall_as_community_benefit":"ALL OF THE SHORTFALL REPORTED ON LINE 7 SHOULD BE CONSIDERED A COMMUNITY BENEFIT. MEDICARE PAYMENTS DO NOT COVER THE COST OF DELIVERING THE SERVICE. PAYMENTS ARE DICTATED NOT BY ACTUAL COST BUT BY WHAT THE GOVERNMENT HAS TO SPEND. THE SHORTFALL HAS TO BE MADE UP BY OTHER PAYORS, IF POSSIBLE, SINCE MEDICARE BENEFICIARIES CANNOT BE BILLED FOR THE MEDICARE SHORTFALL. MEDICARE AS THE LARGEST PAYOR RESULTS IN A SIGNIFICANT SHORTFALL WHICH IS NOT RECOVERABLE GIVEN THAT OTHER PAYORS ARE BARELY PAYING AT COST. THE HOSPITAL DOES NOT DENY ANYONE SERVICE BECAUSE OF THEIR ABILITY TO PAY OR INSURANCE COVERAGE. THE AMOUNT FOR LINE 6 WAS TAKEN FROM THE MEDICARE COST REPORT WORKSHEET D-1 PART II AND WORKSHEET E PART B."}},"ScheduleI":{"reported_domestic_org_grants":0,"reported_domestic_individual_grants":0,"total_domestic_grants":0},"ScheduleF":{"reported_foreign_grants":0},"ScheduleJ":{"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":false,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"PAUL DONOVAN 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IN THE CURRENT YEAR, CONTRIBUTIONS WERE $93,494."},{"identifier":"BONUS","form_and_line_reference":"SCHEDULE J","explanation":"RICHARD PALMISANO, CHRISTOPHER HICKEY, AND ROBERT CALWAY RECEIVE AN ANNUAL BONUS OF UP TO A CERTAIN PERCENT OF BASE SALARY UPON ACCOMPLISHMENT OF GOALS AND OBJECTIVES ESTABLISHED ANNUALLY BY THE BOARD. THEY ARE PAID BY NORTHERN BERKSHIRE HEALTHCARE, WITH A PORTION OF COMPENSATION, INCLUDING BONUS, ALLOCATED TO RELATED ORGANIZATIONS. IN ADDITION, ROBERT CALWAY RECEIVED A RETENTION BONUS."},{"identifier":"COMPENSATION DETERMINATION","form_and_line_reference":"SCHEDULE J, PART I, LINE 3","explanation":"NORTHERN BERKSHIRE HEALTHCARE, A RELATED ORGANIZATION, DETERMINES COMPENSATION FOR THE CEO USING THE FOLLOWING METHODS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -WRITTEN EMPLOYMENT CONTRACT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE"}]},"ScheduleK":{"bond_issues":[{"issuer_ein":42456011,"business_name_line1":"MASSACHUSETTS HEALTH & EDUCATIONAL FACILITIES AUTH","cusip_number":"57586CDS1","date_issued":"2004-10-13T00:00:00","issue_price":26014649,"purpose":"CAPITAL IMPROVEMENTS, REFUND PRIOR","defeased":false,"on_behalf_of_issuer":false,"name":"MASSACHUSETTS HEALTH & EDUCATIONAL FACILITIES AUTH"}],"bond_proceeds":[{"total_proceeds":26014649,"gross_proceeds_in_reserve_funds":2607120,"issuance_costs_from_proceeds":555293,"capital_expenditures":16863419,"amount_defeased":5988818,"amount_unspent":3359871,"substantial_completion_year":2006,"current_refunding":true,"advance_refunding":false,"final_allocation_made":true,"adequate_books_and_records_maintained":true}],"private_business_use":[{"private_business_use_by_others_percentage":0.0,"private_business_concerning_ubi_percentage":0.0,"total_private_business_use_percentage":0.0,"post_issuance_compliance_procedures":false,"management_contract":false,"bond_counsel_routinely_engaged":false,"research_agreements":false,"lease_arrangements":false,"partnership_or_llc_owning_property":false}],"arbitrage":[{"gross_proceeds_invested":false,"gross_proceeds_invested_in_gic":false,"hedge_identified_in_books_and_records":false,"variable_rate_issue":false,"exception_to_rebate":false,"form_8038t_filed":false}]},"ScheduleR":{"tax_exempt_organizations":[{"ein":222563466,"business_name_line1":"NORTHERN BERKSHIRE HEALTHCARE","primary_activities":"MANAGEMENT CO","exempt_code_section":"501(C)(3)","public_charity_status":"7","legal_domicile_state":"MA","direct_controlling_business_name_line1":"NA","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","name":"NORTHERN BERKSHIRE HEALTHCARE","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"},{"ein":222563465,"business_name_line1":"NORTHERN BERKSHIRE REALTY CO","primary_activities":"PROPERTY MGMT","exempt_code_section":"501(C)(3)","public_charity_status":"11A I","legal_domicile_state":"MA","direct_controlling_business_name_line1":"NA","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","name":"NORTHERN BERKSHIRE REALTY CO","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"},{"ein":743253218,"business_name_line1":"NORTHERN BERKSHIRE HEALTHCARE PHYSICIANS","primary_activities":"PHYS SERVICES","exempt_code_section":"501(C)(3)","public_charity_status":"9","legal_domicile_state":"MA","direct_controlling_business_name_line1":"NA","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","name":"NORTHERN BERKSHIRE HEALTHCARE PHYSICIANS","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"},{"ein":222563464,"business_name_line1":"NORTHERN BERKSHIRE COMMUNITY SERVICES","primary_activities":"RESIDENT CARE","exempt_code_section":"501(C)(3)","public_charity_status":"9","legal_domicile_state":"MA","direct_controlling_business_name_line1":"NA","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","name":"NORTHERN BERKSHIRE COMMUNITY SERVICES","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"},{"ein":43470287,"business_name_line1":"REACH COMMUNITY HEALTH FOUNDATION","primary_activities":"COMM. 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A wide range of inpatient and outpatient services are available.","primary_activities":"The organization provides inpatient services, including internal medicine, surgery, pediatrics, gynecology, obstetrics, and psychiatry along with a critical-care unit for intensive-care and coronary care patients. See schedule o for additional details on program service accomplishments and community benefit.\n\nThe hospital has a broad range of outpatient services, including oncology services, a diagnostic imaging department, clinical laboratory services, cardiac testing, rehabilitation center, speech therapy, endoscopy center, and specialty clinics. See schedule o for additional details on program service accomplishments and community benefit.\n\nThe organization operates an emergency room, providing 24-hour service to nearly 21,000 patients each year. See schedule o for additional details on program service accomplishments and community benefit.\n\nThe mission of northern berkshire healthcare is to provide exceptional healthcare from the heart. Northern berkshire healthcare includes north adams regional hospital, the visiting nurse association & hospice of northern berkshire, northern berkshire community services, northern berkshire realty, and the nbh physicians group. A full service community hospital, narh includes 24 hour emergency care, diagnostic imaging, laboratory, birthing center, ob, surgery, psychiatry, physical rehabilitation, inpatient, and outpatient care. It is the primary hospital for over 40,000 residents of northern berkshire county. Reach is the health education and health promotion arm of northern berkshire healthcare and oversees the community benefits program for north adams regional hospital. The mission of reach is to improve the health of the northern berkshire community through education, outreach, advocacy and treatment, in partnership with community members and organizations. Reach is now a department of narh and they continue to have the responsibility of overseeing community health benefits and needs.\n\nNorth adams regional hospital (narh) is a non-profit, acute-care, community hospital licensed by the massachusetts department of health to provide primary-care services, specialty-physician services, diagnostic and treatment services, and wound care services. Narh is a designated medicare-dependent hospital. In addition, the adams and north adams are designated as a low income primary care health professional shortage area for adult primary care, obstetrics and dentistry and maintains a hpsa score of 13. The hospital provides a range of inpatient and outpatient services, including the major specialties of internal medicine, surgery, pediatrics, gynecology, obstetrics, and psychiatry. In addition, it has a critical-care unit, which cares for both intensive-care patients and coronary-care patients. Medical/surgical services: the hospital has one medical/surgical floor with 25 beds including 5 beds for pediatric patients. There are 14 dual occupancy patient rooms and 3 private rooms. This floor was most recently renovated in 2009. Critical care & telemetry unit: this unit can monitor 8 ccu and 4 telemetry patients. The unit was fully renovated in 2006 and is licensed for 13 beds. Five beds are non-monitored and used for telemetry or step-down beds and 8 are critical care beds. Telemetry patients require cardiac monitoring but do not required critical care nursing. Narh does not care for trauma patients. These patients are referred out to tertiary care facilities in either albany or springfield, massachusetts. Pediatrics: the hospital's pediatric unit is located on the medical/surgical floor of the hospital. Obstetrical services: the hospital's maternity ward offers family-centered maternity care, which is a flexible program designed to meet the needs of new parents and infants. The hospital currently has five board certified obstetricians/gynecologists on staff. The entire suite was renovated in 2007. Improvements included the enlargement of the individual patient rooms and the addition of private bathrooms and other amenities. Renovations included five private post-partum rooms, a modernized nursery, three labor and delivery rooms, a new nurses' station and a new fathers' and family waiting area. Surgery department: the hospital maintains three full-service operating rooms (with a fourth used to improve case turnaround and for future expansion) and sixteen pre- and post-operative ambulatory-care operating rooms with nine recovery beds for use in the post-surgical stabilization of patients. The hospital has 30 board certified surgeons, 3 board eligible surgeons, and 1 additional surgeon on staff, representing major surgical specialties such as general surgery, urology, gynecology and orthopedic surgery. The ambulatory surgery department was completely renovated in 2007 and contains three fully-equipped operating rooms, two fully-equipped endoscopy suites, private examination, consultation and recovery rooms, and a new waiting lounge. Psychiatric services: the hospital's psychiatric unit, greylock pavilion (\"greylock\"), commenced operation in 1989. It is a locked unit with 20 beds. Greylock treats a range of patients from age 16 and up and operates a unit specializing in the treatment of patients dually diagnosed with mental illness and substance abuse. Eileen a. Barrett oncology center: in 1994, the hospital opened the eileen a. Barrett oncology center, which was financed by private contributions, to provide treatment of and services to cancer patients. Treatment available at the hospital for oncology care includes chemotherapy and surgery. Outpatient chemotherapy is available at the hospital through collaboration with northern berkshire hematology and oncology. The hospital has five board certified oncologists and referral arrangements with various hospital and hospice programs. Diagnostic imaging services: the hospital provides a range of diagnostic and therapeutic services to both inpatients and outpatients, including 64-slide ct scan, digital echocardiography, nuclear medicine, digital x-ray, digital ultrasound, digital mammography, mri, stereotactic breast biopsy and digital bone densitometry. To meet the growing demand for diagnostic imaging services, the hospital added a picture archiving and communications systems (pacs) in 2007. Mammography, echocardiology, ultrasound and bone densitometry were upgraded to digital technology in 2009 and the mri is scheduled to be replaced with a fixed unit, large bore open magnet in the summer of 2010. The hospital has 3 board certified radiologists on staff. Clinical laboratory: the laboratory offers both anatomical and clinical pathology programs and there are 3 board certified pathologists on staff. The laboratory performs 400,000 tests each year. Pharmacy: the hospital pharmacy maintains an inpatient license only and serves an employee benefit function by filling prescription requests for employees. Pharmacy services to the bedside are delivered via omnicell medication cabinets on each of the medical floors and utilization of the meditech pharmacy module. Pharmacy services are available sixteen hours per day and night hours are covered by cardinal health services via remote access to meditech. Rehabilitation programs: the hospital has a long history as an outpatient rehabilitation provider. The hospital's outpatient rehabilitation center includes a full range of speech therapy, occupational therapy, and physical therapy. The hospital maintains a community rehabilitation service in adams, massachusetts. Endoscopy center: the endoscopy unit of the hospital houses one of the fastest growing services offered by the hospital. The endoscopy suite was renovated as part of the organization's 2004-7 renovation project and full high-definition endoscopy imaging was added in 2009. Outpatient services: the hospital has a broad range of outpatient services. These services include the emergency department; oncology services; a diagnostic imaging department, including mri, 64-slice ct scan, digital x-ray, digital mammography, digital ultrasound, digital bone density; nuclear medicine and a pacs system; clinical laboratory services; cardiac testing; rehabilitation center for physical occupational, and speech therapy; endoscopy center; and specialty clinics. Emergency services: the hospital's emergency department is an active component of the hospital. The hospital's emergency department provides 24-hour service to nearly 21,0000 patients each year. All physicians working in the emergency department are certified in advanced cardiac life support and advanced trauma life support. All nurses working in the emergency department are certified in advanced cardiac life support and pediatric emergency nursing. The emergency department underwent a significant renovation and expansion in 2007. The improvements included an expansion of the service area by 50% with additional exam rooms and the addition of radiology services in the department to expedite diagnostic services. These renovations created an emergency department that contains seventeen rooms, including four new cardiac observation rooms, five acute- and sub-acute examination areas, two private cardiac examination rooms, a new gynecological examination area and a private observation room.","year":2010,"name":"NORTH ADAMS REGIONAL HOSPITAL","phone":"4136643701","website":"WWW.NBHEALTH.ORG","type":"990","principal_officer":"RICHARD PALMISANO","year_formation":1884,"state_legal_domicile":"MA","total_volunteers":116,"tax_period_begin":"2010-10-01T00:00:00","tax_period_end":"2011-09-30T00:00:00","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247, USA","city":"NORTH ADAMS","state":"MA","country":"USA","zip_code":"01247"},"Governance":{"501c3 determination":true,"Number of voting members":15,"Number of independent voting members":13,"Number of employees total":566,"Total Gross UBI":136213,"Net unrelated business taxable income":45598,"Number of employees":566,"Prohibited tax shelter transactions":false,"Taxable party notification":false,"Funds to pay premiums":false,"Premiums Paid":false,"Family or business relationship":false,"Delegation of management duties":true,"Conflict of interest policy":true,"Whistle blower policy":true,"Compensation process for CEO":false,"Compensation process for other employees":true,"Changes to organizing documents":false,"Material diversion or misuse":false,"Members or stockholders":true,"Election of board members":true,"Decisions subject to approval":true,"Minutes of governing body":true,"Local chapters":false,"Form 990 provided to governing body":true,"Document retention policy":true,"Investment in joint venture":false,"Independent audit financial statements":false,"Consolidated audit financial statements":false,"Accountant compile or review":false,"Financial statements audited by independent accountant":false,"Federal grant audit required":false,"Political activities":false,"Donor advised funds":false,"Conservation easements":false,"Collections of art":false,"School":false,"Hospital":true,"Foreign activities":false,"Foreign office":false,"Gaming":false,"Fundraising activities":false,"Professional fundraising":false,"Loan to officer or DQP":false,"Grant to related person":false,"Business relationship through family member":false,"Business relationship with organization":false,"Transfers to exempt non-charitable organization":false},"Revenues":{"value":61616462,"Contributions":{"value":819023,"Other contributions":692258,"Grant revenue":126765},"Program revenue":{"value":60476258,"Total revenue":{"value":60476258,"VARIOUS":60476258},"Unrelated business revenue":136213},"Investment income":{"value":179455,"Investment income total":68770,"Net investment gain":110685,"Income from invest bond proceeds":0},"Other revenues":{"value":141726,"Other total":0,"Royalties revenue":0,"Net rental income":141726,"Net income from fundraising events":0,"Net income from gaming":0,"Net income":0}},"Expenses":{"value":63045339,"Grant expense":{"value":0,"Grants to domestic orgs":0,"Grants to domestic individuals":0,"Foreign grants":0},"Total professional fundraising expense":{"value":0,"Fundraising professional":0},"Benefits paid to members":{"value":0,"Benefits paid to members Total":0},"Salaries":{"value":32661920,"Current officers":996707,"Disqualified persons":0,"Other salaries and wages":23385096,"Pension plan contributions":2697264,"Other employee benefits":3625064,"Payroll taxes":1957789},"Other expenses":{"value":30383419,"Management services":3527389,"Legal":872763,"Accounting":19219,"Lobbying services":0,"Investment management fees":7290,"Other services":9366647,"Advertising":125337,"Office expenses":5370717,"Information technology":6454,"Royalties":0,"Occupancy":926400,"Travel":57135,"Conferences and meetings":79257,"Interest":2405453,"Payments to affiliates":0,"Depreciation and depletion":3201996,"Insurance":540729,"Travel entertainment public officials":0,"Itemized Expenses":{"value":3876633,"VARIOUS":3876633}}},"Assets":{"value":69695108,"Non-interest bearing cash":4742293,"Savings and temp cash investments":4820789,"Pledges and grants receivable":0,"Accounts receivable":5955719,"Inventories for sale or use":1281948,"Prepaid expenses deferred charges":1208426,"Land, building, equipment":31988393,"Investments publicly traded":0,"Other assets":19697540},"Liabilities":{"value":71278500,"Accounts payable, accrued":32753327,"Deferred, revenue":153784,"Tax exempt bond liabilities":28773476,"Secured mortgages and notes payable":7558065,"Unsecured notes loans payable":200956,"Other liabilities":1838892},"Fund balance":{"value":-1583392},"Form990Details":{"program_service_accomplishments":[{"description":"THE ORGANIZATION PROVIDES INPATIENT SERVICES, INCLUDING INTERNAL MEDICINE, SURGERY, PEDIATRICS, GYNECOLOGY, OBSTETRICS, AND PSYCHIATRY ALONG WITH A CRITICAL-CARE UNIT FOR INTENSIVE-CARE AND CORONARY CARE PATIENTS. SEE SCHEDULE O FOR ADDITIONAL DETAILS ON PROGRAM SERVICE ACCOMPLISHMENTS AND COMMUNITY BENEFIT.","expense":22237745,"revenue":22667539},{"description":"THE HOSPITAL HAS A BROAD RANGE OF OUTPATIENT SERVICES, INCLUDING ONCOLOGY SERVICES, A DIAGNOSTIC IMAGING DEPARTMENT, CLINICAL LABORATORY SERVICES, CARDIAC TESTING, REHABILITATION CENTER, SPEECH THERAPY, ENDOSCOPY CENTER, AND SPECIALTY CLINICS. SEE SCHEDULE O FOR ADDITIONAL DETAILS ON PROGRAM SERVICE ACCOMPLISHMENTS AND COMMUNITY BENEFIT.","expense":13746439,"revenue":26901409},{"description":"THE ORGANIZATION OPERATES AN EMERGENCY ROOM, PROVIDING 24-HOUR SERVICE TO NEARLY 21,000 PATIENTS EACH YEAR. 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01/2011","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":249808,"other_compensation":17889,"individual_trustee_or_director":true},{"title":"MEDICAL STAFF PRESIDENT","average_hours_per_week":1.0,"reportable_comp_from_org":5000,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"TRUSTEE","average_hours_per_week":1.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"CFO/TREASURER","average_hours_per_week":10.0,"reportable_comp_from_org":269262,"reportable_comp_from_related_orgs":0,"other_compensation":6387,"officer":true},{"title":"VICE PRESIDENT OF BUSINESS DEV","average_hours_per_week":10.0,"reportable_comp_from_org":144754,"reportable_comp_from_related_orgs":96503,"other_compensation":28335,"key_employee":true},{"title":"ED PHYSICIAN","average_hours_per_week":36.0,"reportable_comp_from_org":267125,"reportable_comp_from_related_orgs":0,"other_compensation":28923,"highest_compensated_employee":true},{"title":"ED PHYSICIAN","average_hours_per_week":36.0,"reportable_comp_from_org":284743,"reportable_comp_from_related_orgs":0,"other_compensation":35280,"highest_compensated_employee":true},{"title":"ED PHYSICIAN","average_hours_per_week":36.0,"reportable_comp_from_org":308884,"reportable_comp_from_related_orgs":0,"other_compensation":29982,"highest_compensated_employee":true},{"title":"HOSPITAL PHYSICIAN","average_hours_per_week":36.0,"reportable_comp_from_org":258090,"reportable_comp_from_related_orgs":0,"other_compensation":23028,"highest_compensated_employee":true},{"title":"ED PHYSICIAN","average_hours_per_week":36.0,"reportable_comp_from_org":331727,"reportable_comp_from_related_orgs":0,"other_compensation":37779,"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":false,"rallies_demonstrations":false,"other_activities":true,"not_described_section_501c3":false},"supplemental_information":[{"identifier":"OTHER LOBBYING ACTIVITIES","form_and_line_reference":"SCHEDULE C, PART II-B, LINE 1(I)","explanation":"THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE MASSACHUSETTS HOSPITAL ASSOCIATION. THESE ORGANIZATIONS LOBBY ON MEMBERS' BEHALF USING 24.60% AND 20.52%, RESPECTIVELY, OF THEIR TIME."}]},"ScheduleD":{"endowment_funds":{"current_year":{"beginning_year_balance":913063,"investment_earnings_or_losses":170,"end_year_balance":913233},"current_year_minus1":{"beginning_year_balance":863063,"contributions":50000,"end_year_balance":913063},"current_year_minus2":{"beginning_year_balance":843063,"contributions":20000,"end_year_balance":863063},"permanent_endowment_eoy_percentage":1.0,"held_by_unrelated_organizations":true,"held_by_related_organizations":false},"land_buildings_equipment":{"land":{"other_cost_or_other_basis":24830,"book_value":24830},"buildings":{"other_cost_or_other_basis":45023740,"book_value":21235407,"depreciation":23788333},"equipment":{"other_cost_or_other_basis":34477566,"book_value":9025909,"depreciation":25451657},"other_land_buildings":{"other_cost_or_other_basis":2725026,"book_value":1702247,"depreciation":1022779},"total_book_value":31988393},"other_assets":{"assets":[{"description":"SECURITY DEPOSITS","book_value":10000},{"description":"LIFE INSURANCE CSV","book_value":89811},{"description":"OTHER ASSETS","book_value":11272},{"description":"BENEFICIAL INT IN TRUSTS","book_value":599811},{"description":"DUE FROM RELATED PARTY","book_value":18726989},{"description":"OTHER RECEIVABLES","book_value":259657}],"total_book_value":19697540},"other_liabilities":{"federal_income_tax_liability":0,"liabilities":[{"description":"EST DUE TO 3RD PARTIES","amount":1511700},{"description":"ASSET RETIREMENT OBLIGATION","amount":327192}],"total_liability":1838892},"supplemental_information":[{"identifier":"INTENDED USES OF ENDOWMENT FUNDS","form_and_line_reference":"SCHEDULE D, PART V, LINE 4","explanation":"ENDOWMENT FUNDS ARE RESTRICTED, BUT THE INCOME GENERATED IS AVAILABLE FOR USE BY THE ORGANIZATION. IT IS USUALLY UNRESTRICTED WITH A SPENDING CAP ON THE AMOUNT OF INCOME. THE EARNINGS MAY BE USED FOR A NUMBER OF USES INCLUDING DAY TO DAY OPERATIONS AND CAPITAL EXPENDITURES."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_400":true,"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":679504,"bad_debt_expense_attributable_to_financial_assistance":78822,"reimbursed_by_medicare":18116293,"cost_of_care_reimbursed_by_medicare":21614928,"medicare_surplus_or_shortfall":-3498635,"costing_methodology_other":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":1082906,"direct_offsetting_revenue":287731,"net_community_benefit_expense":795175,"total_expense_percentage":0.013},"unreimbursed_medicaid":{"total_community_benefit_expense":8196239,"direct_offsetting_revenue":7707456,"net_community_benefit_expense":488783,"total_expense_percentage":0.008},"unreimbursed_costs":{"total_community_benefit_expense":2002099,"direct_offsetting_revenue":1294700,"net_community_benefit_expense":707399,"total_expense_percentage":0.0115},"total_financial_assistance":{"total_community_benefit_expense":11281244,"direct_offsetting_revenue":9289887,"net_community_benefit_expense":1991357,"total_expense_percentage":0.0325},"community_health_services":{"total_community_benefit_expense":122309,"net_community_benefit_expense":122309,"total_expense_percentage":0.002},"subsidized_health_services":{"total_community_benefit_expense":6288832,"direct_offsetting_revenue":4918351,"net_community_benefit_expense":1370481,"total_expense_percentage":0.0223},"total_other_benefits":{"total_community_benefit_expense":6411141,"direct_offsetting_revenue":4918351,"net_community_benefit_expense":1492790,"total_expense_percentage":0.0243},"total_community_benefits":{"total_community_benefit_expense":17692385,"direct_offsetting_revenue":14208238,"net_community_benefit_expense":3484147,"total_expense_percentage":0.0568}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"NORTH ADAMS REGIONAL HOSPITAL","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"NORTH ADAMS REGIONAL HOSPITAL","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"}],"facility_policies":[{"business_name_line1":"NORTH ADAMS REGIONAL HOSPITAL","facility_number":1,"name":"NORTH ADAMS REGIONAL HOSPITAL"}],"other_health_care_facility_count":1,"other_health_care_facilities":[{"business_name_line1":"ADAMS REHABILITATION CENTER","address_line1":"1 COMMERCIAL STREET","city":"ADAMS","state":"MA","zip":"01220","facility_type":"PHYSICAL THERAPY","name":"ADAMS REHABILITATION CENTER","address":"1 COMMERCIAL STREET, ADAMS, MA, 01220"}],"supplemental_information":[{"explanation":"TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE."},{"explanation":"THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1, 3, AND 6."},{"explanation":"THERE WAS NOT A FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS AS NO FORMAL REPORT WAS PREPARED. HOWEVER, THE COSTING METHODOLOGY IS THE HOSPITAL'S COST TO CHARGE RELATIONSHIP APPLIED TO THE BAD DEBT PROVISION WHICH APPEARS ON THE INCOME STATEMENT. THIS SHOULD BE CONSIDERED A COMMUNITY BENEFIT SINCE SERVICE IS PROVIDED REGARDLESS OF ABILITY TO PAY AND FAILURE TO PAY DOES NOT RESULT IN ANY ACTION OTHER THAN SENDING STATEMENTS AND USING A COLLECTIONS AGENCY, TO ATTEMPT TO COLLECT THE PAYMENT. THE HOSPITAL DOES NOT PUT LIENS ON PATIENT ASSETS, REPORT NON PAYMENT TO CREDIT REPORTING AGENCIES, AND DOES NOT CHARGE INTEREST ON PATIENT DEBT. THE HOSPITAL WILL NOT REFUSE TO TREAT A PATIENT THAT CURRENTLY IS IN A BAD DEBT STATUS REGARDING PREVIOUS SERVICES AT THE HOSPITAL. LINE 2 WAS CALCULATED USING THE COST TO CHARGE RATIO TIMES BAD DEBT EXPENSE. BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU."},{"explanation":"ALL OF THE SHORTFALL REPORTED ON LINE 7 SHOULD BE CONSIDERED A COMMUNITY BENEFIT. MEDICARE PAYMENTS DO NOT COVER THE COST OF DELIVERING THE SERVICE. PAYMENTS ARE DICTATED NOT BY ACTUAL COST BUT BY WHAT THE GOVERNMENT HAS TO SPEND. THE SHORTFALL HAS TO BE MADE UP BY OTHER PAYORS, IF POSSIBLE, SINCE MEDICARE BENEFICIARIES CANNOT BE BILLED FOR THE MEDICARE SHORTFALL. MEDICARE AS THE LARGEST PAYOR RESULTS IN A SIGNIFICANT SHORTFALL WHICH IS NOT RECOVERABLE GIVEN THAT OTHER PAYORS ARE BARELY PAYING AT COST. THE HOSPITAL DOES NOT DENY ANYONE SERVICE BECAUSE OF THEIR ABILITY TO PAY OR INSURANCE COVERAGE. THE AMOUNT FOR LINE 6 WAS TAKEN FROM THE MEDICARE COST REPORT WORKSHEET D-1 PART II AND WORKSHEET E PART B."},{"explanation":"PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS. THE HOSPITAL MAY SEEK COLLECTION ACTION FOR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY THE FINANCIAL ASSISTANCE PROGRAM THE PATIENT IS ENROLLED IN. THE HOSPITAL WILL NOT UNDERTAKE COLLECTION ACTION AGAINST ANY INDIVIDUAL THAT HAS BEEN APPROVED FOR MEDICAL HARDSHIP. THE HOSPITAL WILL NOT GARNISH LOW INCOME PATIENTS OR THEIR GUARANTOR'S WAGES OR EXECUTE LIENS. THE HOSPITALS INTERNAL FINANCIAL ASSISTANCE PROGRAM ALLOWS THE HOSPITAL TO CEASE ANY COLLECTION OR BILLING ACTIONS AGAINST A PATIENT WHO IS UNABLE TO PAY THE HOSPITAL BILL AT ANY TIME DURING THE BILLING PROCESS."},{"explanation":"REACH FOR COMMUNITY HEALTH, A DEPARTMENT OF NORTH ADAMS REGIONAL HOSPITAL, HAS OVERSIGHT RESPONSIBILITY FOR THE ORGANIZATION'S COMMUNITY BENEFITS PROGRAM. THE MISSION OF REACH IS TO IMPROVE THE HEALTH OF THE NORTHERN BERKSHIRE COMMUNITY THROUGH EDUCATION, OUTREACH, ADVOCACY, AND TREATMENT, IN PARTNERSHIP WITH COMMUNITY MEMBERS AND ORGANIZATIONS. REACH EXECUTES THE MAJORITY OF COMMUNITY BENEFITS PROGRAMS AND RESPONDS TO THE NEEDS OF THE COMMUNITY WITH ITS DIRECT HEALTH-RELATED PROGRAMMING, MUCH OF WHICH IS GRANT FUNDED. AS A DEPARTMENT OF NORTH ADAMS REGIONAL HOSPITAL, REACH HAS FINANCIAL SUPPORT FOR ITS CORE ADMINISTRATIVE FUNCTIONS; THIS SUPPORT ALLOWS REACH TO MAXIMIZE ITS CAPACITY TO DEVELOP, IMPLEMENT, AND EVALUATE THE NUMEROUS PROGRAMS AND INTERVENTIONS THAT IT PROVIDES IN THE COMMUNITY. A COMMUNITY NEEDS ASSESSMENT WAS CONDUCTED BY THE DIRECTOR OF REACH AND THE VP OF EXTERNAL AFFAIRS OF NORTH ADAMS REGIONAL HOSPITAL IN SEPTEMBER 2009 THAT INCLUDED DATA GATHERING AS WELL AS COMMUNITY SURVEYS. INFORMATION WAS COLLECTED FROM NARH DISCHARGE DATA, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH (MASSCHIP DATA AND BUREAU OF ENVIRONMENTAL HEALTH DATA), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA , U.S. CENSUS 2000 AND NORTHERN BERKSHIRE COMMUNITY COALITION 2009 PREVENTION NEEDS ASSESSMENT SURVEY, WHICH FOCUSES ON YOUTH. THE PROCESS INCLUDED A SURVEY THAT ASKED RESPONDENTS TO RATE DISEASES/HEALTH RISKS BY MOST CONCERN AND RATE CONTRIBUTING FACTORS TO HEALTH BY MOST CONCERN (E.G.: PCP AVAILABILITY). RESPONDENT GROUPS INCLUDED 13 AREA PHYSICIANS (15.6% RESPONSE RATE), 78 COMMUNITY ORGANIZATIONS, AND 1235 NBH CORPORATORS (30% RESPONSE RATE); THEY WERE SURVEYED USING AN INTERNET-BASED SURVEY. TWO GROUPS WERE SURVEYED THROUGH THE NORTHERN BERKSHIRE COMMUNITY COALITION. AT A COMMUNITY PLANNING MEETING THERE WERE 68 RESPONDENTS AND THE COALITION COMMUNITY OUTREACH WORKERS SURVEYED 69 AREA RESIDENTS. BASED UPON ALL OF THE COLLECTED DATA, THE COMMUNITY BENEFITS COMMITTEE IDENTIFIED THE FOLLOWING TARGET POPULATIONS: LOWER INCOME RESIDENTS, YOUTH, 18-34 YEAR OLD, AND ELDERS. THE COMMITTEE SELECTED THE FOLLOWING COMMUNITY BENEFITS PRIORITIES: HEALTHY EATING, PHYSICAL ACTIVITY, EMOTIONAL WELL-BEING & SUPPORT, AND SAFE CHOICES, ALL OF WHICH FALL UNDER THE UMBRELLA OF HEALTHY LIFESTYLES. REACH TARGETS ALL RESIDENTS OF NORTHERN BERKSHIRE COUNTY, WITH A PARTICULAR EMPHASIS ON THE UNINSURED AND UNDERINSURED. PRIMARY PREVENTION AND EARLY DETECTION ARE AT THE CORE OF REACH'S COMMUNITY INITIATIVES. EACH OF REACH'S NUMEROUS PROGRAMS IS BASED ON ASSESSMENT OF COMMUNITY NEED AND INCLUDES SPECIFIC PROCESS AND OUTCOME MEASURES."},{"explanation":"IN NORTH BERKSHIRE COUNTY, ECU-HEALTH CARE, WHICH IS THE AREA'S ENROLLMENT SITE FOR ALL PUBLIC HEALTH PROGRAMS, PROVIDES FINANCIAL COUNSELING SERVICES FOR THE PATIENTS OF NORTH ADAMS REGIONAL HOSPITAL. ALL SELF-PAY PATIENTS, AT TIME OF SERVICE, ARE GIVEN INFORMATION ABOUT ECU-HEALTH CARE'S SERVICES AND ECU-HEALTH CARE CONTACTS PATIENTS IMMEDIATELY. ECU-HEALTH CARE'S PROGRAM SERVICES INCLUDE: - PROVIDING ONE-TO-ONE ENROLLMENT ASSISTANCE FOR ALL PUBLIC HEALTH PROGRAMS. THIS INCLUDES CASE-MANAGEMENT TO INSURE THAT PATIENTS COMPLETE APPLICATION PROCESSES. - CONDUCTING COMMUNITY OUTREACH AND MARKETING CAMPAIGNS FOR MASSHEALTH, COMMONWEALTH CARE, THE MEDICAL SECURITY PLAN, COMMONWEALTH CHOICE, PRESCRIPTION ADVANTAGE, AND ALL OTHER MEDICARE ASSISTANCE PROGRAMS. - WORKING CLOSELY WITH AREA PHYSICIAN GROUPS TO ENSURE THAT APPLICANTS HAVE PRIMARY CARE PROVIDERS. ECU-HEALTH CARE ALSO MAINTAINS A VOLUNTARY PHYSICIAN PROGRAM FOR THOSE NOT ELIGIBLE FOR PUBLIC HEALTH COVERAGE. IN ADDITION, WE HAVE AN AGREEMENT WITH A NUMBER OF LOCAL DENTISTS WHO HAVE AGREED TO PROVIDE SERVICES AT A REDUCED FEE TO LOWER INCOME RESIDENTS WITHOUT DENTAL COVERAGE."},{"explanation":"THE PRIMARY SERVICE AREA (PSA) FOR NORTH ADAMS REGIONAL HOSPITAL (NARH) IS COMPRISED OF THE FOLLOWING TOWNS: NORTH ADAMS, ADAMS, FLORIDA, CLARKSBURG, AND WILLIAMSTOWN. COMPARED TO MASSACHUSETTS, NORTH ADAMS REGIONAL HOSPITAL SERVES A POORER AND LESS EDUCATED POPULATION OF RESIDENTS. THIS IS IMPORTANT BECAUSE RESEARCH HAS DEMONSTRATED THAT SOCIOECONOMIC STATUS AFFECTS HEALTH. ACCORDING TO THE U.S. CENSUS IN 2000, 726 FAMILIES IN THE PSA LIVED BELOW THE FEDERAL POVERTY LEVEL. OF THOSE, 603 INCLUDED RELATED CHILDREN UNDER 18 AND 298 CHILDREN UNDER FIVE. THE RATES OF ELDERS AGE 65 PLUS WHO LIVE BELOW THE POVERTY LEVEL ALSO EXCEED STATE RATES. RESIDENTS WITH LESS THAN A NINTH GRADE EDUCATION EXCEED THAT FOR THE STATE IN ALL BUT WILLIAMSTOWN, AND EVEN THERE THE PERCENTAGE IS ONLY 5/10THS LESS THAN THE STATE RATE. IN ADAMS AND NORTH ADAMS, THE PERCENTAGE OF PEOPLE WITHOUT A HIGH SCHOOL DIPLOMA EXCEEDS THE STATE RATE BY 5.9 PERCENTAGE POINTS AND 6.7 PERCENTAGE POINTS, RESPECTIVELY. BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA (2002-2007) INDICATES THE RATE OF INSURED PEOPLE IN THE BERKSHIRES COMMUNITY HEALTH NETWORK ASSOCIATION (CHNA) IS BELOW THE STATE FOR MEN BUT ABOVE THE STATE RATE OVERALL AND FOR WOMEN. WHILE 13 PERCENT OF MASSACHUSETTS RESIDENTS 18-34 REPORTED BEING WITHOUT INSURANCE, THE RATE IS 19 PERCENT IN THE BERKSHIRES. THE RATE OF UNINSURED PEOPLE 55-64 IS 25 PERCENT HIGHER IN THE BERKSHIRES THAN IN THE STATE, AND TWO PERCENT OF PEOPLE 65+ IN THE BERKSHIRES REPORT BEING UNINSURED. FURTHER, ACCORDING TO BRFSS DATA, THE PERCENTAGE OF RESPONDENTS REPORTING THEY WERE UNABLE TO SEE A DOCTOR IN THE PAST YEAR (2003-2007) DUE TO COST WAS HIGHER OVERALL AND FOR WOMEN THAN THE STATE AND THE PERCENTAGE OF RESPONDENTS IN THE BERKSHIRES AGES 45-54 WHO SAID THEY COULD NOT SEE A DOCTOR BECAUSE OF COST WAS 49 PERCENT HIGHER THAN THE STATE RATE. THE ELDER POPULATION IN NORTHERN BERKSHIRE COMPRISES A MUCH HIGHER PERCENTAGE OF THE POPULATION AS A WHOLE THAN IT DOES FOR THE STATE OF MASSACHUSETTS. THE PERCENTAGE OF THE ELDERLY PEOPLE 85 AND OLDER, IS MORE THAN 1% HIGHER IN NORTHERN BERKSHIRE. THE PERCENTAGES OF THE YOUNGER ELDERS ARE HIGHER IN NORTHERN BERKSHIRE AS WELL."},{"explanation":"THE NORTHERN BERKSHIRE COMMUNITY IS KNOWN FOR ITS COLLABORATIVE APPROACH IN WORKING ON VARIOUS PROBLEMS. TO SERVE OUR TARGET POPULATION, REACH AND NORTH ADAMS REGIONAL HOSPITAL OFTEN COLLABORATE WITH LOCAL ENTITIES, INCLUDING THE FOLLOWING: NORTHERN BERKSHIRE COMMUNITY COALITION; ECU HEALTH CARE; CHILDCARE OF THE BERKSHIRES; BERKSHIRE COMMUNITY ACTION COUNCIL; WILLIAMSTOWN MEDICAL ASSOCIATES AND OTHER MEDICAL GROUPS; BERKSHIRE NURSING FAMILIES; THE HORIZON ADVISORY BOARD AND ELDER SERVICES OF BERKSHIRE COUNTY; AREA COUNCILS ON AGING; NORTHERN BERKSHIRE UNITED WAY; TARGET: HUNGER; WILLIAMS COLLEGE; MASSACHUSETTS COLLEGE OF LIBERAL ARTS (MCLA); THE NORTH ADAMS PUBLIC SCHOOLS, ADAMS AND CHESHIRE REGIONAL SCHOOL DISTRICT, MASS MOCA AND THE BERKSHIRE FOOD PROJECT, AMONG OTHERS."},{"explanation":"IN ADDITION TO THE GOVERNING BOARD, THE NBH BOARD OF TRUSTEES, A COMMUNITY BOARD, NORTHERN BERKSHIRE HEALTHCARE CORPORATORS, SERVES AS LIAISON TO THE NORTHERN BERKSHIRE COMMUNITY AND HAS THE AUTHORITY TO APPROVE NOMINATIONS TO THE BOARD OF CORPORATORS AND THE NBH BOARD OF TRUSTEES, AND MAKE ADJUSTMENTS IN THE BYLAWS GOVERNING NBH. CORPORATORS ARE ELECTED FROM THE COMMUNITIES SERVED BY NBH AND ITS AFFILIATES."},{"explanation":"NORTH ADAMS REGIONAL HOSPITAL IS A SUBSIDIARY OF NORTHERN BERKSHIRE HEALTHCARE, LOCATED IN BERKSHIRE COUNTY IN THE NORTHWESTERN CORNER OF MASSACHUSETTS. THE HEALTH SYSTEM, IN ADDITION TO THE HOSPITAL, INCLUDES THE VISITING NURSE ASSOCIATION AND HOSPICE OF NORTHERN BERKSHIRE. REACH FOR COMMUNITY HEALTH EXECUTES THE MAJORITY OF COMMUNITY BENEFITS PROGRAMS AND RESPONDS TO THE NEEDS OF THE COMMUNITY WITH ITS DIRECT HEALTH-RELATED PROGRAMMING, MUCH OF WHICH IS GRANT FUNDED. AS A DEPARTMENT OF NORTH ADAMS REGIONAL HOSPITAL, REACH HAS FINANCIAL SUPPORT FOR ITS CORE ADMINISTRATIVE FUNCTIONS; THIS SUPPORT ALLOWS REACH TO MAXIMIZE ITS CAPACITY TO DEVELOP, IMPLEMENT, AND EVALUATE THE NUMEROUS PROGRAMS AND INTERVENTIONS THAT IT PROVIDES IN THE COMMUNITY. THE REACH COMMUNITY BENEFITS COMMITTEE, IS A STANDING COMMITTEE OF THE NBH BOARD OF TRUSTEES AND HAS DIRECT OVERSIGHT OF THE NARH COMMUNITY BENEFIT PLAN AND SUBSEQUENT ACTIVITY. REACH FOR COMMUNITY HEALTH IS MANAGED BY A DIRECTOR WITH OVERSIGHT BY THE SENIOR EXECUTIVE GROUP OF NORTHERN BERKSHIRE HEALTHCARE."},{"explanation":"MASSACHUSETTS"}]},"ScheduleI":{"reported_domestic_org_grants":0,"reported_domestic_individual_grants":0,"total_domestic_grants":0},"ScheduleF":{"reported_foreign_grants":0},"ScheduleJ":{"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":false,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"RICHARD PALMISANO","base_compensation_filing_org":340527,"bonus_filing_org":47500,"bonus_related_orgs":2500,"compensation_based_on_related_orgs":17922,"comp_report_prior_990_filing_org":122695,"comp_report_prior_990_related_orgs":6458,"deferred_compensation_filing_org":17480,"deferred_compensation_related_orgs":920,"nontaxable_benefits_filing_org":18697,"nontaxable_benefits_related_orgs":984,"other_compensation_filing_org":135099,"other_compensation_related_orgs":7111,"total_compensation_filing_org":559303,"total_compensation_related_orgs":29437,"name":"RICHARD PALMISANO"},{"person_name":"CHRISTOPHER 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IN THE CURRENT YEAR, HE TOOK A DISTRIBUTION FROM THE PLAN OF $129,153. THIS AMOUNT WAS INCLUDED IN HIS COMPENSATION IN PART VII AND SCHEDULE J, PART II, AND IS SHOWN IN SCHEDULE J, PART II, COLUMN F, AS IT WAS INCLUDED IN INCOME ON PRIOR FORM 990'S AS CONTRIBUTIONS."},{"identifier":"BONUSES","form_and_line_reference":"SCHEDULE J","explanation":"RICHARD PALMISANO, CHRISTOPHER HICKEY, AND ROBERT CALWAY RECEIVE AN ANNUAL BONUS OF UP TO A CERTAIN PERCENT OF BASE SALARY UPON ACCOMPLISHMENT OF GOALS AND OBJECTIVES ESTABLISHED ANNUALLY BY THE BOARD. THEY ARE PAID BY NORTHERN BERKSHIRE HEALTHCARE, WITH A PORTION OF COMPENSATION, INCLUDING BONUS, ALLOCATED TO RELATED ORGANIZATIONS."}]},"ScheduleK":{"bond_issues":[{"issuer_ein":42456011,"business_name_line1":"MASSACHUSETTS HEALTH & FACILITIES AUTH","cusip_number":"57586CDS1","date_issued":"2004-10-13T00:00:00","issue_price":26014649,"purpose":"CAPITAL IMPROVEMENTS, REFUND PRIOR","defeased":false,"on_behalf_of_issuer":false,"pool_financing":false,"name":"MASSACHUSETTS HEALTH & FACILITIES AUTH"}],"bond_proceeds":[{"total_proceeds":26014649,"gross_proceeds_in_reserve_funds":2607120,"issuance_costs_from_proceeds":555293,"capital_expenditures":16863419,"refunding_escrow":5988818,"substantial_completion_year":2006,"current_refunding":true,"advance_refunding":false,"final_allocation_made":true,"adequate_books_and_records_maintained":true}],"private_business_use":[{"private_business_use_by_others_percentage":0.0,"private_business_concerning_ubi_percentage":0.0,"total_private_business_use_percentage":0.0,"post_issuance_compliance_procedures":false,"management_contract":false,"bond_counsel_routinely_engaged":false,"research_agreements":false,"lease_arrangements":false,"partnership_or_llc_owning_property":false}],"arbitrage":[{"gross_proceeds_invested":false,"gross_proceeds_invested_in_gic":false,"hedge_identified_in_books_and_records":false,"variable_rate_issue":false,"exception_to_rebate":false,"form_8038t_filed":false}]},"ScheduleR":{"tax_exempt_organizations":[{"ein":222563466,"business_name_line1":"NORTHERN BERKSHIRE HEALTHCARE","primary_activities":"MANAGEMENT CO","exempt_code_section":"501(C)(3)","public_charity_status":"7","legal_domicile_state":"MA","direct_controlling_business_name_line1":"NA","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","name":"NORTHERN BERKSHIRE HEALTHCARE","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"},{"ein":222563465,"business_name_line1":"NORTHERN BERKSHIRE REALTY CO","primary_activities":"PROPERTY MGMT","exempt_code_section":"501(C)(3)","public_charity_status":"11A I","legal_domicile_state":"MA","direct_controlling_business_name_line1":"NA","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","name":"NORTHERN BERKSHIRE REALTY CO","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"},{"ein":743253218,"business_name_line1":"NORTHERN BERKSHIRE HEALTHCARE PHYSICIANS","primary_activities":"PHYS SERVICES","exempt_code_section":"501(C)(3)","public_charity_status":"9","legal_domicile_state":"MA","direct_controlling_business_name_line1":"NA","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","name":"NORTHERN BERKSHIRE HEALTHCARE PHYSICIANS","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"},{"ein":222563464,"business_name_line1":"NORTHERN BERKSHIRE COMMUNITY SERVICES","primary_activities":"RESIDENT CARE","exempt_code_section":"501(C)(3)","public_charity_status":"9","legal_domicile_state":"MA","direct_controlling_business_name_line1":"NA","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","name":"NORTHERN BERKSHIRE COMMUNITY SERVICES","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"},{"ein":42910547,"business_name_line1":"VISITING NURSE ASSOCIATION & HOSPICE","primary_activities":"HOME HEALTH","exempt_code_section":"501(C)(3)","public_charity_status":"9","legal_domicile_state":"MA","direct_controlling_business_name_line1":"NA","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","name":"VISITING NURSE ASSOCIATION & HOSPICE","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"}],"transaction_flags":{"gift_grant_or_capital_contribution_from_other_org":false,"gift_grant_or_capital_contribution_to_other_org":false,"loans_or_guarantees_from_other_org":true,"loans_or_guarantees_to_other_org":true,"performance_of_services_by_other_orgs":true,"performance_of_services_for_other_orgs":false,"sharing_of_facilities":true,"sharing_of_paid_employees":true,"reimbursement_paid_by_other_org":true,"reimbursement_paid_to_other_org":true,"rental_of_facilities_from_other_orgs":false,"rental_of_facilities_to_other_orgs":false,"purchase_of_assets_from_other_org":false,"sale_of_assets_to_other_org":false,"exchange_of_assets":false,"receipt_of_interest_annuities_rents_royalties":false,"other_transfer_from_other_org":true,"other_transfer_to_other_org":false}},"source_xml":"201222219349300712_public.xml"}],"Latest":{"Organization":{"Hours":[0],"Total Compensation":[0],"Direct compensation":[0],"Other compensation":[0]},"Basic":{"mission":"North adams regional hospital provides primary care and specialty physician services to individuals in the community. A wide range of inpatient and outpatient services are available.","primary_activities":"The organization provides inpatient services, including internal medicine, surgery, pediatrics, gynecology, obstetrics, and psychiatry along with a critical-care unit for intensive-care and coronary care patients. See schedule o for additional details on program service accomplishments and community benefit.\n\nThe hospital has a broad range of outpatient services, including oncology services, a diagnostic imaging department, clinical laboratory services, cardiac testing, rehabilitation center, speech therapy, endoscopy center, and specialty clinics. See schedule o for additional details on program service accomplishments and community benefit.\n\nThe organization operates an emergency room, providing 24-hour service to nearly 21,000 patients each year. See schedule o for additional details on program service accomplishments and community benefit.\n\nThe mission of northern berkshire healthcare is to provide exceptional healthcare from the heart. Northern berkshire healthcare includes north adams regional hospital, the visiting nurse association & hospice of northern berkshire, northern berkshire community services, northern berkshire realty, and the nbh physicians group. A full service community hospital, narh includes 24 hour emergency care, diagnostic imaging, laboratory, birthing center, ob, surgery, psychiatry, physical rehabilitation, inpatient, and outpatient care. It is the primary hospital for over 40,000 residents of northern berkshire county. Reach is the health education and health promotion arm of northern berkshire healthcare and oversees the community benefits program for north adams regional hospital. The mission of reach is to improve the health of the northern berkshire community through education, outreach, advocacy and treatment, in partnership with community members and organizations. Reach is now a department of narh and they continue to have the responsibility of overseeing community health benefits and needs.\n\nNorth adams regional hospital (narh) is a non-profit, acute-care, community hospital licensed by the massachusetts department of health to provide primary-care services, specialty-physician services, diagnostic and treatment services, and wound care services. Narh is a designated medicare-dependent hospital. In addition, the adams and north adams are designated as a low income primary care health professional shortage area for adult primary care, obstetrics and dentistry and maintains a hpsa score of 13. The hospital provides a range of inpatient and outpatient services, including the major specialties of internal medicine, surgery, pediatrics, gynecology, obstetrics, and psychiatry. In addition, it has a critical-care unit, which cares for both intensive-care patients and coronary-care patients. Medical/surgical services: the hospital has one medical/surgical floor with 25 beds including 5 beds for pediatric patients. There are 14 dual occupancy patient rooms and 3 private rooms. This floor was most recently renovated in 2009. Critical care & telemetry unit: this unit can monitor 8 ccu and 4 telemetry patients. The unit was fully renovated in 2006 and is licensed for 13 beds. Five beds are non-monitored and used for telemetry or step-down beds and 8 are critical care beds. Telemetry patients require cardiac monitoring but do not required critical care nursing. Narh does not care for trauma patients. These patients are referred out to tertiary care facilities in either albany or springfield, massachusetts. Pediatrics: the hospital's pediatric unit is located on the medical/surgical floor of the hospital. Obstetrical services: the hospital's maternity ward offers family-centered maternity care, which is a flexible program designed to meet the needs of new parents and infants. The hospital currently has five board certified obstetricians/gynecologists on staff. The entire suite was renovated in 2007. Improvements included the enlargement of the individual patient rooms and the addition of private bathrooms and other amenities. Renovations included five private post-partum rooms, a modernized nursery, three labor and delivery rooms, a new nurses' station and a new fathers' and family waiting area. Surgery department: the hospital maintains three full-service operating rooms (with a fourth used to improve case turnaround and for future expansion) and sixteen pre- and post-operative ambulatory-care operating rooms with nine recovery beds for use in the post-surgical stabilization of patients. The hospital has 30 board certified surgeons, 3 board eligible surgeons, and 1 additional surgeon on staff, representing major surgical specialties such as general surgery, urology, gynecology and orthopedic surgery. The ambulatory surgery department was completely renovated in 2007 and contains three fully-equipped operating rooms, two fully-equipped endoscopy suites, private examination, consultation and recovery rooms, and a new waiting lounge. Psychiatric services: the hospital's psychiatric unit, greylock pavilion (\"greylock\"), commenced operation in 1989. It is a locked unit with 20 beds. Greylock treats a range of patients from age 16 and up and operates a unit specializing in the treatment of patients dually diagnosed with mental illness and substance abuse. Eileen a. Barrett oncology center: in 1994, the hospital opened the eileen a. Barrett oncology center, which was financed by private contributions, to provide treatment of and services to cancer patients. Treatment available at the hospital for oncology care includes chemotherapy and surgery. Outpatient chemotherapy is available at the hospital through collaboration with northern berkshire hematology and oncology. The hospital has five board certified oncologists and referral arrangements with various hospital and hospice programs. Diagnostic imaging services: the hospital provides a range of diagnostic and therapeutic services to both inpatients and outpatients, including 64-slide ct scan, digital echocardiography, nuclear medicine, digital x-ray, digital ultrasound, digital mammography, mri, stereotactic breast biopsy and digital bone densitometry. To meet the growing demand for diagnostic imaging services, the hospital added a picture archiving and communications systems (pacs) in 2007. Mammography, echocardiology, ultrasound and bone densitometry were upgraded to digital technology in 2009 and the mri is scheduled to be replaced with a fixed unit, large bore open magnet in the summer of 2010. The hospital has 3 board certified radiologists on staff. Clinical laboratory: the laboratory offers both anatomical and clinical pathology programs and there are 3 board certified pathologists on staff. The laboratory performs 400,000 tests each year. Pharmacy: the hospital pharmacy maintains an inpatient license only and serves an employee benefit function by filling prescription requests for employees. Pharmacy services to the bedside are delivered via omnicell medication cabinets on each of the medical floors and utilization of the meditech pharmacy module. Pharmacy services are available sixteen hours per day and night hours are covered by cardinal health services via remote access to meditech. Rehabilitation programs: the hospital has a long history as an outpatient rehabilitation provider. The hospital's outpatient rehabilitation center includes a full range of speech therapy, occupational therapy, and physical therapy. The hospital maintains a community rehabilitation service in adams, massachusetts. Endoscopy center: the endoscopy unit of the hospital houses one of the fastest growing services offered by the hospital. The endoscopy suite was renovated as part of the organization's 2004-7 renovation project and full high-definition endoscopy imaging was added in 2009. Outpatient services: the hospital has a broad range of outpatient services. These services include the emergency department; oncology services; a diagnostic imaging department, including mri, 64-slice ct scan, digital x-ray, digital mammography, digital ultrasound, digital bone density; nuclear medicine and a pacs system; clinical laboratory services; cardiac testing; rehabilitation center for physical occupational, and speech therapy; endoscopy center; and specialty clinics. Emergency services: the hospital's emergency department is an active component of the hospital. The hospital's emergency department provides 24-hour service to nearly 21,0000 patients each year. All physicians working in the emergency department are certified in advanced cardiac life support and advanced trauma life support. All nurses working in the emergency department are certified in advanced cardiac life support and pediatric emergency nursing. The emergency department underwent a significant renovation and expansion in 2007. The improvements included an expansion of the service area by 50% with additional exam rooms and the addition of radiology services in the department to expedite diagnostic services. 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THESE ORGANIZATIONS LOBBY ON MEMBERS' BEHALF USING 24.60% AND 20.52%, RESPECTIVELY, OF THEIR TIME."}]},"ScheduleD":{"endowment_funds":{"current_year":{"beginning_year_balance":913063,"investment_earnings_or_losses":170,"end_year_balance":913233},"current_year_minus1":{"beginning_year_balance":863063,"contributions":50000,"end_year_balance":913063},"current_year_minus2":{"beginning_year_balance":843063,"contributions":20000,"end_year_balance":863063},"permanent_endowment_eoy_percentage":1.0,"held_by_unrelated_organizations":true,"held_by_related_organizations":false},"land_buildings_equipment":{"land":{"other_cost_or_other_basis":24830,"book_value":24830},"buildings":{"other_cost_or_other_basis":45023740,"book_value":21235407,"depreciation":23788333},"equipment":{"other_cost_or_other_basis":34477566,"book_value":9025909,"depreciation":25451657},"other_land_buildings":{"other_cost_or_other_basis":2725026,"book_value":1702247,"depreciation":1022779},"total_book_value":31988393},"other_assets":{"assets":[{"description":"SECURITY DEPOSITS","book_value":10000},{"description":"LIFE INSURANCE CSV","book_value":89811},{"description":"OTHER ASSETS","book_value":11272},{"description":"BENEFICIAL INT IN TRUSTS","book_value":599811},{"description":"DUE FROM RELATED PARTY","book_value":18726989},{"description":"OTHER RECEIVABLES","book_value":259657}],"total_book_value":19697540},"other_liabilities":{"federal_income_tax_liability":0,"liabilities":[{"description":"EST DUE TO 3RD PARTIES","amount":1511700},{"description":"ASSET RETIREMENT OBLIGATION","amount":327192}],"total_liability":1838892},"supplemental_information":[{"identifier":"INTENDED USES OF ENDOWMENT FUNDS","form_and_line_reference":"SCHEDULE D, PART V, LINE 4","explanation":"ENDOWMENT FUNDS ARE RESTRICTED, BUT THE INCOME GENERATED IS AVAILABLE FOR USE BY THE ORGANIZATION. IT IS USUALLY UNRESTRICTED WITH A SPENDING CAP ON THE AMOUNT OF INCOME. THE EARNINGS MAY BE USED FOR A NUMBER OF USES INCLUDING DAY TO DAY OPERATIONS AND CAPITAL EXPENDITURES."}]},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_400":true,"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":679504,"bad_debt_expense_attributable_to_financial_assistance":78822,"reimbursed_by_medicare":18116293,"cost_of_care_reimbursed_by_medicare":21614928,"medicare_surplus_or_shortfall":-3498635,"costing_methodology_other":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":1082906,"direct_offsetting_revenue":287731,"net_community_benefit_expense":795175,"total_expense_percentage":0.013},"unreimbursed_medicaid":{"total_community_benefit_expense":8196239,"direct_offsetting_revenue":7707456,"net_community_benefit_expense":488783,"total_expense_percentage":0.008},"unreimbursed_costs":{"total_community_benefit_expense":2002099,"direct_offsetting_revenue":1294700,"net_community_benefit_expense":707399,"total_expense_percentage":0.0115},"total_financial_assistance":{"total_community_benefit_expense":11281244,"direct_offsetting_revenue":9289887,"net_community_benefit_expense":1991357,"total_expense_percentage":0.0325},"community_health_services":{"total_community_benefit_expense":122309,"net_community_benefit_expense":122309,"total_expense_percentage":0.002},"subsidized_health_services":{"total_community_benefit_expense":6288832,"direct_offsetting_revenue":4918351,"net_community_benefit_expense":1370481,"total_expense_percentage":0.0223},"total_other_benefits":{"total_community_benefit_expense":6411141,"direct_offsetting_revenue":4918351,"net_community_benefit_expense":1492790,"total_expense_percentage":0.0243},"total_community_benefits":{"total_community_benefit_expense":17692385,"direct_offsetting_revenue":14208238,"net_community_benefit_expense":3484147,"total_expense_percentage":0.0568}},"hospital_facility_count":1,"hospital_facilities":[{"facility_number":1,"business_name_line1":"NORTH ADAMS REGIONAL HOSPITAL","address_line1":"71 HOSPITAL AVENUE","city":"NORTH ADAMS","state":"MA","zip":"01247","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"NORTH ADAMS REGIONAL HOSPITAL","address":"71 HOSPITAL AVENUE, NORTH ADAMS, MA, 01247"}],"facility_policies":[{"business_name_line1":"NORTH ADAMS REGIONAL HOSPITAL","facility_number":1,"name":"NORTH ADAMS REGIONAL HOSPITAL"}],"other_health_care_facility_count":1,"other_health_care_facilities":[{"business_name_line1":"ADAMS REHABILITATION CENTER","address_line1":"1 COMMERCIAL STREET","city":"ADAMS","state":"MA","zip":"01220","facility_type":"PHYSICAL THERAPY","name":"ADAMS REHABILITATION CENTER","address":"1 COMMERCIAL STREET, ADAMS, MA, 01220"}],"supplemental_information":[{"explanation":"TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE."},{"explanation":"THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATIONS ON IRS WORKSHEETS 1, 3, AND 6."},{"explanation":"THERE WAS NOT A FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS AS NO FORMAL REPORT WAS PREPARED. HOWEVER, THE COSTING METHODOLOGY IS THE HOSPITAL'S COST TO CHARGE RELATIONSHIP APPLIED TO THE BAD DEBT PROVISION WHICH APPEARS ON THE INCOME STATEMENT. THIS SHOULD BE CONSIDERED A COMMUNITY BENEFIT SINCE SERVICE IS PROVIDED REGARDLESS OF ABILITY TO PAY AND FAILURE TO PAY DOES NOT RESULT IN ANY ACTION OTHER THAN SENDING STATEMENTS AND USING A COLLECTIONS AGENCY, TO ATTEMPT TO COLLECT THE PAYMENT. THE HOSPITAL DOES NOT PUT LIENS ON PATIENT ASSETS, REPORT NON PAYMENT TO CREDIT REPORTING AGENCIES, AND DOES NOT CHARGE INTEREST ON PATIENT DEBT. THE HOSPITAL WILL NOT REFUSE TO TREAT A PATIENT THAT CURRENTLY IS IN A BAD DEBT STATUS REGARDING PREVIOUS SERVICES AT THE HOSPITAL. LINE 2 WAS CALCULATED USING THE COST TO CHARGE RATIO TIMES BAD DEBT EXPENSE. BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING POVERTY LIMIT DEMOGRAPHIC INFORMATION OBTAINED THROUGH THE US CENSUS BUREAU."},{"explanation":"ALL OF THE SHORTFALL REPORTED ON LINE 7 SHOULD BE CONSIDERED A COMMUNITY BENEFIT. MEDICARE PAYMENTS DO NOT COVER THE COST OF DELIVERING THE SERVICE. PAYMENTS ARE DICTATED NOT BY ACTUAL COST BUT BY WHAT THE GOVERNMENT HAS TO SPEND. THE SHORTFALL HAS TO BE MADE UP BY OTHER PAYORS, IF POSSIBLE, SINCE MEDICARE BENEFICIARIES CANNOT BE BILLED FOR THE MEDICARE SHORTFALL. MEDICARE AS THE LARGEST PAYOR RESULTS IN A SIGNIFICANT SHORTFALL WHICH IS NOT RECOVERABLE GIVEN THAT OTHER PAYORS ARE BARELY PAYING AT COST. THE HOSPITAL DOES NOT DENY ANYONE SERVICE BECAUSE OF THEIR ABILITY TO PAY OR INSURANCE COVERAGE. THE AMOUNT FOR LINE 6 WAS TAKEN FROM THE MEDICARE COST REPORT WORKSHEET D-1 PART II AND WORKSHEET E PART B."},{"explanation":"PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS. THE HOSPITAL MAY SEEK COLLECTION ACTION FOR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY THE FINANCIAL ASSISTANCE PROGRAM THE PATIENT IS ENROLLED IN. THE HOSPITAL WILL NOT UNDERTAKE COLLECTION ACTION AGAINST ANY INDIVIDUAL THAT HAS BEEN APPROVED FOR MEDICAL HARDSHIP. THE HOSPITAL WILL NOT GARNISH LOW INCOME PATIENTS OR THEIR GUARANTOR'S WAGES OR EXECUTE LIENS. THE HOSPITALS INTERNAL FINANCIAL ASSISTANCE PROGRAM ALLOWS THE HOSPITAL TO CEASE ANY COLLECTION OR BILLING ACTIONS AGAINST A PATIENT WHO IS UNABLE TO PAY THE HOSPITAL BILL AT ANY TIME DURING THE BILLING PROCESS."},{"explanation":"REACH FOR COMMUNITY HEALTH, A DEPARTMENT OF NORTH ADAMS REGIONAL HOSPITAL, HAS OVERSIGHT RESPONSIBILITY FOR THE ORGANIZATION'S COMMUNITY BENEFITS PROGRAM. THE MISSION OF REACH IS TO IMPROVE THE HEALTH OF THE NORTHERN BERKSHIRE COMMUNITY THROUGH EDUCATION, OUTREACH, ADVOCACY, AND TREATMENT, IN PARTNERSHIP WITH COMMUNITY MEMBERS AND ORGANIZATIONS. REACH EXECUTES THE MAJORITY OF COMMUNITY BENEFITS PROGRAMS AND RESPONDS TO THE NEEDS OF THE COMMUNITY WITH ITS DIRECT HEALTH-RELATED PROGRAMMING, MUCH OF WHICH IS GRANT FUNDED. AS A DEPARTMENT OF NORTH ADAMS REGIONAL HOSPITAL, REACH HAS FINANCIAL SUPPORT FOR ITS CORE ADMINISTRATIVE FUNCTIONS; THIS SUPPORT ALLOWS REACH TO MAXIMIZE ITS CAPACITY TO DEVELOP, IMPLEMENT, AND EVALUATE THE NUMEROUS PROGRAMS AND INTERVENTIONS THAT IT PROVIDES IN THE COMMUNITY. A COMMUNITY NEEDS ASSESSMENT WAS CONDUCTED BY THE DIRECTOR OF REACH AND THE VP OF EXTERNAL AFFAIRS OF NORTH ADAMS REGIONAL HOSPITAL IN SEPTEMBER 2009 THAT INCLUDED DATA GATHERING AS WELL AS COMMUNITY SURVEYS. INFORMATION WAS COLLECTED FROM NARH DISCHARGE DATA, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH (MASSCHIP DATA AND BUREAU OF ENVIRONMENTAL HEALTH DATA), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA , U.S. CENSUS 2000 AND NORTHERN BERKSHIRE COMMUNITY COALITION 2009 PREVENTION NEEDS ASSESSMENT SURVEY, WHICH FOCUSES ON YOUTH. THE PROCESS INCLUDED A SURVEY THAT ASKED RESPONDENTS TO RATE DISEASES/HEALTH RISKS BY MOST CONCERN AND RATE CONTRIBUTING FACTORS TO HEALTH BY MOST CONCERN (E.G.: PCP AVAILABILITY). RESPONDENT GROUPS INCLUDED 13 AREA PHYSICIANS (15.6% RESPONSE RATE), 78 COMMUNITY ORGANIZATIONS, AND 1235 NBH CORPORATORS (30% RESPONSE RATE); THEY WERE SURVEYED USING AN INTERNET-BASED SURVEY. TWO GROUPS WERE SURVEYED THROUGH THE NORTHERN BERKSHIRE COMMUNITY COALITION. AT A COMMUNITY PLANNING MEETING THERE WERE 68 RESPONDENTS AND THE COALITION COMMUNITY OUTREACH WORKERS SURVEYED 69 AREA RESIDENTS. BASED UPON ALL OF THE COLLECTED DATA, THE COMMUNITY BENEFITS COMMITTEE IDENTIFIED THE FOLLOWING TARGET POPULATIONS: LOWER INCOME RESIDENTS, YOUTH, 18-34 YEAR OLD, AND ELDERS. THE COMMITTEE SELECTED THE FOLLOWING COMMUNITY BENEFITS PRIORITIES: HEALTHY EATING, PHYSICAL ACTIVITY, EMOTIONAL WELL-BEING & SUPPORT, AND SAFE CHOICES, ALL OF WHICH FALL UNDER THE UMBRELLA OF HEALTHY LIFESTYLES. REACH TARGETS ALL RESIDENTS OF NORTHERN BERKSHIRE COUNTY, WITH A PARTICULAR EMPHASIS ON THE UNINSURED AND UNDERINSURED. PRIMARY PREVENTION AND EARLY DETECTION ARE AT THE CORE OF REACH'S COMMUNITY INITIATIVES. EACH OF REACH'S NUMEROUS PROGRAMS IS BASED ON ASSESSMENT OF COMMUNITY NEED AND INCLUDES SPECIFIC PROCESS AND OUTCOME MEASURES."},{"explanation":"IN NORTH BERKSHIRE COUNTY, ECU-HEALTH CARE, WHICH IS THE AREA'S ENROLLMENT SITE FOR ALL PUBLIC HEALTH PROGRAMS, PROVIDES FINANCIAL COUNSELING SERVICES FOR THE PATIENTS OF NORTH ADAMS REGIONAL HOSPITAL. ALL SELF-PAY PATIENTS, AT TIME OF SERVICE, ARE GIVEN INFORMATION ABOUT ECU-HEALTH CARE'S SERVICES AND ECU-HEALTH CARE CONTACTS PATIENTS IMMEDIATELY. ECU-HEALTH CARE'S PROGRAM SERVICES INCLUDE: - PROVIDING ONE-TO-ONE ENROLLMENT ASSISTANCE FOR ALL PUBLIC HEALTH PROGRAMS. THIS INCLUDES CASE-MANAGEMENT TO INSURE THAT PATIENTS COMPLETE APPLICATION PROCESSES. - CONDUCTING COMMUNITY OUTREACH AND MARKETING CAMPAIGNS FOR MASSHEALTH, COMMONWEALTH CARE, THE MEDICAL SECURITY PLAN, COMMONWEALTH CHOICE, PRESCRIPTION ADVANTAGE, AND ALL OTHER MEDICARE ASSISTANCE PROGRAMS. - WORKING CLOSELY WITH AREA PHYSICIAN GROUPS TO ENSURE THAT APPLICANTS HAVE PRIMARY CARE PROVIDERS. ECU-HEALTH CARE ALSO MAINTAINS A VOLUNTARY PHYSICIAN PROGRAM FOR THOSE NOT ELIGIBLE FOR PUBLIC HEALTH COVERAGE. IN ADDITION, WE HAVE AN AGREEMENT WITH A NUMBER OF LOCAL DENTISTS WHO HAVE AGREED TO PROVIDE SERVICES AT A REDUCED FEE TO LOWER INCOME RESIDENTS WITHOUT DENTAL COVERAGE."},{"explanation":"THE PRIMARY SERVICE AREA (PSA) FOR NORTH ADAMS REGIONAL HOSPITAL (NARH) IS COMPRISED OF THE FOLLOWING TOWNS: NORTH ADAMS, ADAMS, FLORIDA, CLARKSBURG, AND WILLIAMSTOWN. COMPARED TO MASSACHUSETTS, NORTH ADAMS REGIONAL HOSPITAL SERVES A POORER AND LESS EDUCATED POPULATION OF RESIDENTS. THIS IS IMPORTANT BECAUSE RESEARCH HAS DEMONSTRATED THAT SOCIOECONOMIC STATUS AFFECTS HEALTH. ACCORDING TO THE U.S. CENSUS IN 2000, 726 FAMILIES IN THE PSA LIVED BELOW THE FEDERAL POVERTY LEVEL. OF THOSE, 603 INCLUDED RELATED CHILDREN UNDER 18 AND 298 CHILDREN UNDER FIVE. THE RATES OF ELDERS AGE 65 PLUS WHO LIVE BELOW THE POVERTY LEVEL ALSO EXCEED STATE RATES. RESIDENTS WITH LESS THAN A NINTH GRADE EDUCATION EXCEED THAT FOR THE STATE IN ALL BUT WILLIAMSTOWN, AND EVEN THERE THE PERCENTAGE IS ONLY 5/10THS LESS THAN THE STATE RATE. IN ADAMS AND NORTH ADAMS, THE PERCENTAGE OF PEOPLE WITHOUT A HIGH SCHOOL DIPLOMA EXCEEDS THE STATE RATE BY 5.9 PERCENTAGE POINTS AND 6.7 PERCENTAGE POINTS, RESPECTIVELY. BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) DATA (2002-2007) INDICATES THE RATE OF INSURED PEOPLE IN THE BERKSHIRES COMMUNITY HEALTH NETWORK ASSOCIATION (CHNA) IS BELOW THE STATE FOR MEN BUT ABOVE THE STATE RATE OVERALL AND FOR WOMEN. WHILE 13 PERCENT OF MASSACHUSETTS RESIDENTS 18-34 REPORTED BEING WITHOUT INSURANCE, THE RATE IS 19 PERCENT IN THE BERKSHIRES. THE RATE OF UNINSURED PEOPLE 55-64 IS 25 PERCENT HIGHER IN THE BERKSHIRES THAN IN THE STATE, AND TWO PERCENT OF PEOPLE 65+ IN THE BERKSHIRES REPORT BEING UNINSURED. FURTHER, ACCORDING TO BRFSS DATA, THE PERCENTAGE OF RESPONDENTS REPORTING THEY WERE UNABLE TO SEE A DOCTOR IN THE PAST YEAR (2003-2007) DUE TO COST WAS HIGHER OVERALL AND FOR WOMEN THAN THE STATE AND THE PERCENTAGE OF RESPONDENTS IN THE BERKSHIRES AGES 45-54 WHO SAID THEY COULD NOT SEE A DOCTOR BECAUSE OF COST WAS 49 PERCENT HIGHER THAN THE STATE RATE. THE ELDER POPULATION IN NORTHERN BERKSHIRE COMPRISES A MUCH HIGHER PERCENTAGE OF THE POPULATION AS A WHOLE THAN IT DOES FOR THE STATE OF MASSACHUSETTS. THE PERCENTAGE OF THE ELDERLY PEOPLE 85 AND OLDER, IS MORE THAN 1% HIGHER IN NORTHERN BERKSHIRE. THE PERCENTAGES OF THE YOUNGER ELDERS ARE HIGHER IN NORTHERN BERKSHIRE AS WELL."},{"explanation":"THE NORTHERN BERKSHIRE COMMUNITY IS KNOWN FOR ITS COLLABORATIVE APPROACH IN WORKING ON VARIOUS PROBLEMS. TO SERVE OUR TARGET POPULATION, REACH AND NORTH ADAMS REGIONAL HOSPITAL OFTEN COLLABORATE WITH LOCAL ENTITIES, INCLUDING THE FOLLOWING: NORTHERN BERKSHIRE COMMUNITY COALITION; ECU HEALTH CARE; CHILDCARE OF THE BERKSHIRES; BERKSHIRE COMMUNITY ACTION COUNCIL; WILLIAMSTOWN MEDICAL ASSOCIATES AND OTHER MEDICAL GROUPS; BERKSHIRE NURSING FAMILIES; THE HORIZON ADVISORY BOARD AND ELDER SERVICES OF BERKSHIRE COUNTY; AREA COUNCILS ON AGING; NORTHERN BERKSHIRE UNITED WAY; TARGET: HUNGER; WILLIAMS COLLEGE; MASSACHUSETTS COLLEGE OF LIBERAL ARTS (MCLA); THE NORTH ADAMS PUBLIC SCHOOLS, ADAMS AND CHESHIRE REGIONAL SCHOOL DISTRICT, MASS MOCA AND THE BERKSHIRE FOOD PROJECT, AMONG OTHERS."},{"explanation":"IN ADDITION TO THE GOVERNING BOARD, THE NBH BOARD OF TRUSTEES, A COMMUNITY BOARD, NORTHERN BERKSHIRE HEALTHCARE CORPORATORS, SERVES AS LIAISON TO THE NORTHERN BERKSHIRE COMMUNITY AND HAS THE AUTHORITY TO APPROVE NOMINATIONS TO THE BOARD OF CORPORATORS AND THE NBH BOARD OF TRUSTEES, AND MAKE ADJUSTMENTS IN THE BYLAWS GOVERNING NBH. CORPORATORS ARE ELECTED FROM THE COMMUNITIES SERVED BY NBH AND ITS AFFILIATES."},{"explanation":"NORTH ADAMS REGIONAL HOSPITAL IS A SUBSIDIARY OF NORTHERN BERKSHIRE HEALTHCARE, LOCATED IN BERKSHIRE COUNTY IN THE NORTHWESTERN CORNER OF MASSACHUSETTS. THE HEALTH SYSTEM, IN ADDITION TO THE HOSPITAL, INCLUDES THE VISITING NURSE ASSOCIATION AND HOSPICE OF NORTHERN BERKSHIRE. REACH FOR COMMUNITY HEALTH EXECUTES THE MAJORITY OF COMMUNITY BENEFITS PROGRAMS AND RESPONDS TO THE NEEDS OF THE COMMUNITY WITH ITS DIRECT HEALTH-RELATED PROGRAMMING, MUCH OF WHICH IS GRANT FUNDED. AS A DEPARTMENT OF NORTH ADAMS REGIONAL HOSPITAL, REACH HAS FINANCIAL SUPPORT FOR ITS CORE ADMINISTRATIVE FUNCTIONS; THIS SUPPORT ALLOWS REACH TO MAXIMIZE ITS CAPACITY TO DEVELOP, IMPLEMENT, AND EVALUATE THE NUMEROUS PROGRAMS AND INTERVENTIONS THAT IT PROVIDES IN THE COMMUNITY. THE REACH COMMUNITY BENEFITS COMMITTEE, IS A STANDING COMMITTEE OF THE NBH BOARD OF TRUSTEES AND HAS DIRECT OVERSIGHT OF THE NARH COMMUNITY BENEFIT PLAN AND SUBSEQUENT ACTIVITY. REACH FOR COMMUNITY HEALTH IS MANAGED BY A DIRECTOR WITH OVERSIGHT BY THE SENIOR EXECUTIVE GROUP OF NORTHERN BERKSHIRE HEALTHCARE."},{"explanation":"MASSACHUSETTS"}]},"ScheduleI":{"reported_domestic_org_grants":0,"reported_domestic_individual_grants":0,"total_domestic_grants":0},"ScheduleF":{"reported_foreign_grants":0},"ScheduleJ":{"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":false,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"RICHARD PALMISANO","base_compensation_filing_org":340527,"bonus_filing_org":47500,"bonus_related_orgs":2500,"compensation_based_on_related_orgs":17922,"comp_report_prior_990_filing_org":122695,"comp_report_prior_990_related_orgs":6458,"deferred_compensation_filing_org":17480,"deferred_compensation_related_orgs":920,"nontaxable_benefits_filing_org":18697,"nontaxable_benefits_related_orgs":984,"other_compensation_filing_org":135099,"other_compensation_related_orgs":7111,"total_compensation_filing_org":559303,"total_compensation_related_orgs":29437,"name":"RICHARD PALMISANO"},{"person_name":"CHRISTOPHER 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MD","base_compensation_filing_org":327218,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":19293,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":18486,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":4509,"other_compensation_related_orgs":0,"total_compensation_filing_org":369506,"total_compensation_related_orgs":0,"name":"PAUL DONOVAN MD"}],"supplemental_information":[{"identifier":"COMPENSATION DETERMINATION","form_and_line_reference":"SCHEDULE J, PART I, LINE 3","explanation":"NORTHERN BERKSHIRE HEALTHCARE, A RELATED ORGANIZATION, DETERMINES COMPENSATION FOR THE CEO USING THE FOLLOWING METHODS: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -WRITTEN EMPLOYMENT CONTRACT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE"},{"identifier":"SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN","form_and_line_reference":"SCHEDULE J, PART I, LINE 4B","explanation":"RICHARD PALMISANO, CEO/PRESIDENT, PARTICIPATES IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. IN THE CURRENT YEAR, HE TOOK A DISTRIBUTION FROM THE PLAN OF $129,153. THIS AMOUNT WAS INCLUDED IN HIS COMPENSATION IN PART VII AND SCHEDULE J, PART II, AND IS SHOWN IN SCHEDULE J, PART II, COLUMN F, AS IT WAS INCLUDED IN INCOME ON PRIOR FORM 990'S AS CONTRIBUTIONS."},{"identifier":"BONUSES","form_and_line_reference":"SCHEDULE J","explanation":"RICHARD PALMISANO, CHRISTOPHER HICKEY, AND ROBERT CALWAY RECEIVE AN ANNUAL BONUS OF UP TO A CERTAIN PERCENT OF BASE SALARY UPON ACCOMPLISHMENT OF GOALS AND OBJECTIVES ESTABLISHED ANNUALLY BY THE BOARD. THEY ARE PAID BY NORTHERN BERKSHIRE HEALTHCARE, WITH A PORTION OF COMPENSATION, INCLUDING BONUS, ALLOCATED TO RELATED ORGANIZATIONS."}]},"ScheduleK":{"bond_issues":[{"issuer_ein":42456011,"business_name_line1":"MASSACHUSETTS HEALTH & FACILITIES AUTH","cusip_number":"57586CDS1","date_issued":"2004-10-13T00:00:00","issue_price":26014649,"purpose":"CAPITAL IMPROVEMENTS, REFUND PRIOR","defeased":false,"on_behalf_of_issuer":false,"pool_financing":false,"name":"MASSACHUSETTS HEALTH & FACILITIES 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