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THE CORPORATION MAY ON OCCASION ALSO APPEAR BEFORE A LEGISLATIVE COMMITTEE CONFER WITH LEGISLATORS OR OTHERWISE ATTEMPT TO INFLUENCE LEGISLATION. HOWEVER, IT WILL NOT PARTICIPATE, IN ANY WAY, IN POLITICAL CAMPAIGNS. THE CORPORATION'S INVOLVEMENT IN LEGISLATIVE ACTIVITIES CONSTITUTES AN INSUBSTANTIAL PART OF ITS 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organization files its annual community benefit report with the Attorney General of Massachusetts as part of the Partners HealthCare System, Inc. Community Benefit Report. http://www.cbsys.ago.state.ma.us/healthcare/hccbar.asp"},{"explanation":"The bad debt expense subtracted from total expenses for purposes of calculating the percentage column = $2,549,000"},{"explanation":"The amounts reported on the charity care and other community benefits table were calculated using the best available data using a cost accounting system or a cost to charge ratio. In most cases, a cost accounting system was used and the system addresses all patient segments and directly assigns costs to individual services."},{"explanation":"The cost of bad debt was calculated using the best available data which included a cost accounting system or a cost to charge ratio. The patient liability is reduced by all payments and insurance contractual adjustments. Previously applied patient discounts are reversed prior to placement in bad debt if the patient does not pay after the prescribed collection process or if the patient reneges on a previously agreed payment schedule."},{"explanation":"In addition to free care and inadequate funding from the Medicaid and Medicare programs, there are significant losses related to self-pay patients who fail to make payment for services rendered or insured patients who fail to remit co-payments and deductibles as required under the applicable health insurance arrangement. The provision of bad debts of $2,549,000 in 2012 and $2,979,000 in 2011 represents charges for services provided that are deemed to be uncollectible. The estimated cost of providing these services was approximately $1,177,279 and $1,212,812 for 2012 and 2011, respectively."},{"explanation":"All costs reported on the Medicare cost report have been determined in accordance with Medicare cost-finding principles. Costs allocable to Medicare patients are limited to certain services and derived in a number of ways, including average cost per day times Medicare days and ratio of cost to charges applied to charges for ancillary services provided to Medicare beneficiaries. The determination of allowable costs via the Medicare cost report excludes the cost and revenue associated with certain services, limits the costs recognized for other services and excludes certain costs of doing business. In addition, the Medicare cost report methodology does not allocate costs to Medicare beneficiaries as precisely as cost accounting systems, which, for example, account for the more intensive nursing care Medicare beneficiaries often require. Taking these factors into account, total revenue received and the full and accurate cost associated with all Medicare services are $17,830,657 and $17,617,912 respectively, resulting in a total Medicare surplus of $212,745."},{"explanation":"The Hospital will take reasonable steps to ensure that no collection actions, including telephone calls, statements or letters, are initiated for those patient balances that may be exempt from collection action by regulation, including patients determined to be Low Income, or enrolled in Mass Health, CMSP, EAEDC, Healthy Start or Center Care excepting those deductibles and co-payments determined by those programs to be a patient responsibility. If it is determined that a patient is in one of those categories then all collection actions (except applicable co-payments and deductibles) with the patient will cease for services occurring during the patient's period of eligibility."},{"explanation":"Martha's Vineyard Hospital is continually evaluating and responding to the health needs of the community on the Vineyard. Needs and priorities are identified through the collection and analysis of data from various sources. Community Partners include: Alzheimer's Services of Cape Cod & the Islands American Red Cross of MV Boston MedFlight Caregivers Homes Continuum of Care Committee (island-wide) Dukes County Health Council DoN Community Health Initiatives Working Group Dukes County Public Health Committee Dukes County Veteran's Agency Elder Affairs Committee Hospice of Martha's Vineyard Island Hospice Martha's Vineyard Association of EMTs Martha's Vineyard Community Services Martha's Vineyard Regional High School Martha's Vineyard Vision Fellowship Martha's Vineyard Whole Health Alliance Municipal Health Officers (six island towns) Network Health Towns of Oak Bluffs, Tisbury & Edgartown Ambulance Services Tri-town Ambulance Service Vineyard Health Care Access Program Visiting Nurse Association Wampanoag Tribe of Gay Head (Aquinnah) Windemere Nursing and Rehabilitation Key Accomplishments of Reporting Year: Completed the process to prepare RFP's to allocate DON funds in October 2010. Initial funding issued in December 2010. Although the process took longer than anticipated, the hospital worked closely with the Department of Public Health, the Dukes County Health Council as well as with the larger community and various stakeholders, over the course of three years to put together the process to disburse the funds. Although the DPH changed its guidelines as well as the focus of the priorities during the process, the hospital continued to work with all groups under the new guidelines on the allocation of funds. The next round of funding will take place in FY13. Patient and Family Council developed operating guidelines and bylaws for the committee. The group then worked with hospital staff on a plan to improve patient flow and wait times in the Emergency Department. Plans for Next Reporting Year: The hospital has the following community benefit initiatives underway for the next reporting year: -Expanding health information internally (brochures and clinical service information)and externally (website) with emphasis on translation for the extensive Brazilian Portuguese community on the Island in an effort to more fully engage this segment of the Vineyard community."},{"explanation":"The Hospital will seek to identify patients who may be uninsured or inadequately insured in order to provide counseling and assistance. The Hospital will provide financial counseling to these patients and their families, including screening for eligibility for other sources of coverage, such as government programs, and providing information regarding all acceptable methods of payment of the Hospital bill. The Hospital will encourage patients who are potentially eligible for coverage by MassHealth, Commonwealth Care, the Health Safety Net, or other government programs to apply for coverage and shall assist the patient in applying for benefits. Patients may also apply for and be approved for coverage by the HSN for co-insurance or other deductibles not covered by their primary insurance plan. The Hospital will post a notice (signs) of the availability of financial assistance programs and describe where to go to for assistance in the following locations: 1. Inpatient, clinic, emergency department, and community health center admission and/or registration areas; 2. Financial Counseling waiting areas 3. Central admission/registration areas that are open to patients 4. Business office waiting areas that are open to patients Signs will be translated into other languages to the extent that the language is the primary language of more than 10% of residents in the Hospital's service. Posted signs will be clearly visible and legible to patients visiting these areas."},{"explanation":"The Martha's Vineyard Hospital (MVH) Board of Trustees approved the following community benefit mission statement on March 14, 1996: Martha's Vineyard Hospital's Community Benefit mission is to strengthen hospital-community partnerships. The hospital continues to develop, in concert with other providers and social service agencies, comprehensive community-based primary and preventive health care programs that come from a needs assessment of major health issues for the people who live on and visit Martha's Vineyard. Martha's Vineyard Hospital (MVH) serves the year-round island community, as well as, visitors to the island. The hospital has long recognized and provided special programs that serve children, women, the elderly, and the underprivileged and will work to expand such programs. MVH will continue to respond to the needs of different cultures as they emerge in our community. Martha's Vineyard Hospital has a tradition of providing services to the uninsured and underinsured. MVH will continue to expend resources for charity care; no one is turned away because of an inability to pay. Recognizing that health care does not simply mean responding to illness, Martha's Vineyard Hospital pledges its resources to help the members of the island community protect themselves from disease and accidents through prevention and wellness programs that include education and screening. Martha's Vineyard Hospital will pursue these goals within the framework of the formal Community Benefits Plan adopted by the Board of Trustees, administration, and staff. This will include a review of the community's health status through an ongoing needs assessment. At all times, the process will include the opportunity for public input and comment. MVH is committed to the continued promotion of cooperative and collaborative relationships with other providers, agencies, schools, and with officials in the various towns that make up the island of Martha's Vineyard."},{"explanation":"Community building activities are described in detail in the organization's community benefit report as filed with the Attorney General of Massachusetts. This report can be accessed at: http://www.cbsys.ago.state.ma.us/healthcare/hccbar.asp In addition, the Hospital's commitment to the environment is demonstrated by the LEED Certification for the new hospital addition which is described at: http://mvhospital.com/about/our-commitment/ Martha's Vineyard Hospital, Inc.'s governing body is comprised of community leaders who are guided by the hospital's mission to deliver excellence in patient care. Surplus funds are used to further the organization's tax exempt missions of patient care. See http://www.mvhospital.com for more information."},{"explanation":"Each of the hospitals that comprise the Partners network has a community benefit planning and service delivery structure. Each of these entities has filed a separate community benefit report. Coordinating activities on a system-wide basis is Matt Fishman, Vice President for Community Health for Partners HealthCare."},{"explanation":"States with which the organization (or a related organization) files a community benefit report: Massachusetts."}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":226680,"reported_domestic_individual_grants":0,"reported_domestic_org_grants_program_services":226680,"total_501c3_and_government_organizations":5,"grants":[{"ein":42301598,"irc_section":"501(c)(3)","cash":51670,"purpose":"Community Benefit Program","address_line1":"111 Edgartown Road","city":"Oak Bluffs","state":"MA","zip":"02557","name":"Martha's Vineyard Community Services","address":"111 Edgartown Road, Oak Bluffs, MA, 02557"},{"ein":222557839,"irc_section":"501(c)(3)","cash":51670,"purpose":"Community Benefit Program","address_line1":"15 Merchants Court","city":"V Haven","state":"MA","zip":"02568","name":"Visiting Nurse Association","address":"15 Merchants Court, V Haven, MA, 02568"},{"ein":46001143,"irc_section":"501(c)(3)","cash":51670,"purpose":"Community Benefit Program","address_line1":"PO Box 5158","city":"Edgartown","state":"MA","zip":"02539","name":"Town of Edgartown","address":"PO Box 5158, Edgartown, MA, 02539"},{"ein":46001255,"irc_section":"501(c)(3)","cash":51670,"purpose":"Community Benefit Program","address_line1":"PO Box 1327","city":"Oak Bluffs","state":"MA","zip":"02557","name":"Town of Oak Bluffs","address":"PO Box 1327, Oak Bluffs, MA, 02557"},{"ein":46001422,"irc_section":"501(c)(3)","cash":10000,"purpose":"Community Benefit Program","address_line1":"PO Box 190","city":"Edgartown","state":"MA","zip":"02539","name":"County of Dukes County","address":"PO Box 190, Edgartown, MA, 02539"}],"total_domestic_grants":226680,"total_domestic_program_services":226680,"detail_org_grants_total":216680,"detail_domestic_grants_total":216680,"supplemental_information":[{"identifier":"Use of Grants/Donations","form_and_line_reference":"Schedule I, Part I, Line 2","explanation":"Martha's Vineyard Hospital, Inc. makes donations to various tax-exempt organiYations, local municipalities and community groups. These donations are made by the Hospital to entities and community groups that share the Hospital's goals and missions."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"Martha's Vineyard Hospital, Inc. makes donations to various tax-exempt organiYations, local municipalities and community groups. These donations are made by the Hospital to entities and community groups that share the Hospital's goals and missions.","form_and_line_reference":"Schedule I, Part I, Line 2"}},"ScheduleF":{"reported_foreign_grants":0},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"form_990_of_other_organizations":true,"written_employment_contract":true,"compensation_survey_or_study":true,"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":false,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"TIMOTHY J 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BOARD MEMBERS WHO ARE ALSO EMPLOYED BY THE CORPORATION OR A PARTNERS AFFILIATE RECEIVE COMPENSATION ONLY FOR THEIR SERVICES AS EMPLOYEES."},{"identifier":"Establishing CEO Compensation","form_and_line_reference":"Part I, Line 3","explanation":"The Chief Executive Officer's Compensation was established using the following: - Compensation Committee - Independent Compensation Consultant - Form 990 of Other Organizations - Compensation Survey or Study - Approval by the Board or Compensation Committee The Compensation Committee of the Board of Trustees of Martha's Vineyard Hospital makes a recommendation for approval by the Board of Trustees of the Massachusetts General Hospital, an affiliated tax-exempt organization."},{"identifier":"Participation in a supplemental nonqualified retirement plan","form_and_line_reference":"Part I, Line 4B","explanation":"The amount listed below is included in the compensation total reported on Schedule J: Brent L. Henry - $128,079 Andrew L. 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Walsh - $18,475 Thomas Lenkowski - $5,850 James Ferriter - $8,850"}]},"ScheduleL":{"business_transactions_involving_interested_persons":[{"person_name":"K Casper MD","relationship":"Pil - family","description":"salary","amount":224238,"sharing_of_revenues":false,"name":"K Casper MD"}]},"ScheduleM":{"policies":{"any_property_that_must_be_held":false,"review_process_unusual_noncash_gifts":true,"third_parties_used":false},"noncash_contributions":{"works_of_art":{"reported":true,"revenue_reported_on_990":50750,"contribution_count":51,"method_of_determining_revenues":"FMV"}}},"ScheduleR":{"tax_exempt_organizations":[{"ein":43230035,"business_name_line1":"Partners HealthCare System Inc (PHS)","primary_activities":"Healthcare","exempt_code_section":"501(c)(3)","public_charity_status":"7","controlled_organization":false,"legal_domicile_state":"MA","direct_controlling_business_name_line1":"NA","address_line1":"Prudential Tower 800 Boylston 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THE CORPORATION MAY ON OCCASION ALSO APPEAR BEFORE A LEGISLATIVE COMMITTEE CONFER WITH LEGISLATORS OR OTHERWISE ATTEMPT TO INFLUENCE LEGISLATION. HOWEVER, IT WILL NOT PARTICIPATE, IN ANY WAY, IN POLITICAL CAMPAIGNS. THE CORPORATION'S INVOLVEMENT IN LEGISLATIVE ACTIVITIES CONSTITUTES AN INSUBSTANTIAL PART OF ITS ACTIVITIES."}]},"ScheduleD":{"land_buildings_equipment":{"land":{"other_cost_or_other_basis":1268585,"book_value":1268585},"buildings":{"other_cost_or_other_basis":16329579,"book_value":5164655,"depreciation":11164924},"equipment":{"other_cost_or_other_basis":9654103,"book_value":2028703,"depreciation":7625400},"other_land_buildings":{"other_cost_or_other_basis":49976994,"book_value":49862781,"depreciation":114213},"total_book_value":58324724},"securities":{"other_securities":[{"description":"INV IN PARTNERS POOL INV ACCT","book_value":20265922,"method_of_valuation":"F"}],"total_book_value":20265922},"other_liabilities":{"federal_income_tax_liability":0,"liabilities":[{"description":"DUE TO THIRD PARTY PAYORS","amount":3054679},{"description":"ASSET RETIREMENT OBLIGATION","amount":629868},{"description":"OTHER LONG-TERM LIABILTIIES","amount":938853}],"total_liability":4623400}},"ScheduleG":{"fundraising_events":{"event1":{"name":"Tournament","gross_receipts":107767,"charitable_contributions":107767,"cash_prizes":0,"noncash_prizes":8946,"rent_facility_costs":0,"food_and_beverage":4195,"entertainment":0,"other_direct_expenses":13497},"event2":{"name":"Run/Walk Event","gross_receipts":24916,"charitable_contributions":24916,"cash_prizes":0,"noncash_prizes":2975,"rent_facility_costs":0,"food_and_beverage":185,"entertainment":0,"other_direct_expenses":3762},"other_events":{"event_count":0},"total":{"gross_receipts":132683,"charitable_contributions":132683,"cash_prizes":0,"noncash_prizes":11921,"rent_facility_costs":0,"food_and_beverage":4380,"entertainment":0,"other_direct_expenses":17259},"direct_expense_summary":33560,"net_income_summary":-33560}},"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":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":false,"bad_debt_expense":1140302,"reimbursed_by_medicare":13375401,"cost_of_care_reimbursed_by_medicare":15270052,"medicare_surplus_or_shortfall":-1894651,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"total_community_benefit_expense":1884601,"direct_offsetting_revenue":736613,"net_community_benefit_expense":1147988,"total_expense_percentage":0.0242},"unreimbursed_medicaid":{"total_community_benefit_expense":4618221,"direct_offsetting_revenue":4148930,"net_community_benefit_expense":469291,"total_expense_percentage":0.0099},"total_financial_assistance":{"total_community_benefit_expense":6502822,"direct_offsetting_revenue":4885543,"net_community_benefit_expense":1617279,"total_expense_percentage":0.0341},"total_community_benefits":{"total_community_benefit_expense":6502822,"direct_offsetting_revenue":4885543,"net_community_benefit_expense":1617279,"total_expense_percentage":0.0341}},"hospital_facilities":[{"business_name_line1":"Martha's Vineyard Hospital","address_line1":"Linton Lane PO Box 1477","city":"Oak Bluffs","state":"MA","zip":"02557","licensed_hospital":true,"general_medical_and_surgical":true,"childrens_hospital":true,"emergency_room_24_hours":true,"name":"Martha's Vineyard Hospital","address":"Linton Lane PO Box 1477, Oak Bluffs, MA, 02557"}],"part_vi_explanations":{"affiliated_health_care_system":"Each of the hospitals that comprise the Partners network has a community benefit planning and service delivery structure. Each of these entities has filed a separate community benefit report. Coordinating activities on a system-wide basis is Matt Fishman, Vice President for Community Health for Partners HealthCare.","annual_community_benefit":"The organization files its annual community benefit report with the Attorney General of Massachusetts as part of the Partners HealthCare System, Inc. Community Benefit Report. http://www.cbsys.ago.state.ma.us/healthcare/hccbar.asp","bad_debt_footnote":"In addition to free care and inadequate funding from the Medicaid and Medicare programs, there are significant losses related to self-pay patients who fail to make payment for services rendered or insured patients who fail to remit co-payments and deductibles as required under the applicable health insurance arrangement. The provision of bad debts of $2,811,000 in 2010 and $2,429,000 in 2009 represents charges for services provided that are deemed to be uncollectible. The estimated cost of providing these services was approximately $1,144,416 and $1,019,208 for 2010 and 2009, respectively.","community_building_activities":"Community building activities are described in detail in the organization's community benefit report as filed with the Attorney General of Massachusetts. This report can be accessed at: http://www.cbsys.ago.state.ma.us/healthcare/hccbar.asp In addition, the Hospital's commitment to the environment is demonstrated by the LEED Certification for the new hospital addition which is described at: http://www.mvhospital.com/mvh.php?page=about&pid=1&section=leeds0","community_information":"The Martha's Vineyard Hospital (MVH) Board of Trustees approved the following community benefit mission statement on March 14, 1996: Martha's Vineyard Hospital's Community Benefit mission is to strengthen hospital-community partnerships. The hospital continues to develop, in concert with other providers and social service agencies, comprehensive community-based primary and preventive health care programs that come from a needs assessment of major health issues for the people who live on and visit Martha's Vineyard. Martha's Vineyard Hospital (MVH) serves the year-round island community, as well as, visitors to the island. The hospital has long recognized and provided special programs that serve children, women, the elderly, and the underprivileged and will work to expand such programs. MVH will continue to respond to the needs of different cultures as they emerge in our community. Martha's Vineyard Hospital has a tradition of providing services to the uninsured and underinsured. MVH will continue to expend resources for charity care; no one is turned away because of an inability to pay. Recognizing that health care does not simply mean responding to illness, Martha's Vineyard Hospital pledges its resources to help the members of the island community protect themselves from disease and accidents through prevention and wellness programs that include education and screening. Martha's Vineyard Hospital will pursue these goals within the framework of the formal Community Benefits Plan adopted by the Board of Trustees, administration, and staff. This will include a review of the community's health status through an ongoing needs assessment. At all times, the process will include the opportunity for public input and comment. MVH is committed to the continued promotion of cooperative and collaborative relationships with other providers, agencies, schools, and with officials in the various towns that make up the island of Martha's Vineyard. Martha's Vineyard Hospital develops and ensures the vitality of its Community Benefit Program in collaboration with the following community organizations and groups: - Martha's Vineyard Community Services - Dukes County Health Council - Dukes County Public Health Committee - Vineyard Health Care Access Program - Partners Community Benefit Report 3 - Martha's Vineyard Association of EMTs - Towns of Oak Bluffs, Tisbury, and Edgartown Ambulance Services - Tri-town Ambulance Service - Municipal Health Officers (six island towns) - Continuum of Care Committee (island-wide) - Rural Scholars Advisory Committee - Elder Affairs Committee - Oral Health Working Group - Youth Task Force - Mental Health and Substance Abuse Working Group - Wampanoag Tribe of Gay Head (Aquinnah) - Island Health Plan - Elder Services of Cape Cod and The Islands - Windemere Nursing and Rehabilitation Center - Family Planning of Martha's Vineyard - Hospice of Martha's Vineyard - Martha's Vineyard Whole Health Alliance - Dukes County Veteran's Agency - Martha's Vineyard Regional High School - Visiting Nurse Service - Plum TV - Martha's Vineyard Vision Fellowship In addition to analyzing the data that is outlined above, Martha's Vineyard Hospital continues to review feedback from the community to help direct the Community Benefit Program. This feedback is collected from various sources each year. In FY2009 those sources included: - Dukes County Health Council - Continuum of Care Committee - MV Community Services - Island Health Care - Wampanoag Tribe of Gay Head (Aquinnah) - Vineyard Medical Group - MV Whole Health Alliance - Youth Task Force - Martha's Vineyard Community Services Domestic Violence survey - Elder Services of Cape Cod and the Islands Needs Assessment - Community Health Clerkship Survey - Injury and Fall Prevention for the Elders of Martha's Vineyard - Editorials and letters in the local newspapers - Correspondence with the hospital from members of the community - The hospital's Annual Appeals, which include a section for community comments - Press Ganey survey material generated by patients who visit various departments in the hospital, including the Emergency Department, Ambulatory Surgery Unit, Rehabilitation and Wellness Department, and Patient Care Unit","debt_collection_policy":"Per Massachusetts regulation, patients that qualify for charity care are exempt from collection practices. The Hospital will take reasonable steps to ensure that no collection actions, including telephone calls, statements or letters, are initiated for those patient balances that may be exempt from collection action by regulation, including patients determined to be Low Income, or enrolled in Mass Health, CMSP, EAEDC, Healthy Start or Center Care excepting those deductibles and co-payments determined by those programs to be a patient responsibility. If it is determined that a patient is in one of those categories then all collection actions (except applicable co-payments and deductibles) with the patient will cease for services occurring during the patient's period of eligibility.","income_based_criteria":"Partners' hospitals are tax-exempt entities, whose underlying mission is to provide services to all in need of medical care. Its hospitals maintain an \"open door\" policy and do not discriminate on the basis of race, color, national origin, citizenship, alienage, religion, creed, gender, sexual preference, age, or disability.","needs_assessment":"Martha's Vineyard Hospital is continually evaluating and responding to the health needs of the community on the Vineyard. Needs and priorities are identified through the collection and analysis of data from various sources that include the following: - The Massachusetts Department of Public Health (DPH), including the DPH Rural Health Advisory Council - Martha's Vineyard Hospital's Emergency Department - Dukes County Health Council (DCHC) - formed in 1995, the Council's membership is made up of a variety of consumers and provider agencies and in FY2009 included five hospital representatives. The DCHC is a state-recognized subdivision of Community Health Network Area (CHNA) 27. MVH participates in the DCHC and its various working groups, including the Rural Scholars Advisory Committee, Elder Affairs Committee, Oral Health Working Group, Youth Task Force, and the Mental Health and Substance Abuse Working Group. - Dukes County Public Health Committee, with input from approximately 100 providers, consumers, institutional representatives, and local opinion leaders, evaluates the efficiency and effectiveness of the local public health system, as well as, gaps in services and still-needed linkages between providers. Press Ganey surveys are given to hospital patients who use the Emergency Department, Ambulatory Surgery Department, and Acute Care Services.","patient_education_assistance":"The Hospital will seek to identify patients who may be uninsured or inadequately insured in order to provide counseling and assistance. The Hospital will provide financial counseling to these patients and their families, including screening for eligibility for other sources of coverage, such as government programs, and providing information regarding all acceptable methods of payment of the Hospital bill. The Hospital will encourage patients who are potentially eligible for coverage by MassHealth, Commonwealth Care, the Health Safety Net, or other government programs to apply for coverage and shall assist the patient in applying for benefits. Patients may also apply for and be approved for coverage by the HSN for co-insurance or other deductibles not covered by their primary insurance plan. The Hospital will post a notice (signs) of the availability of financial assistance programs and describe where to go to for assistance in the following locations: 1. Inpatient, clinic, emergency department, and community health center admission and/or registration areas; 2. Financial Counseling waiting areas 3. Central admission/registration areas that are open to patients 4. Business office waiting areas that are open to patients Signs will be translated into other languages to the extent that the language is the primary language of more than 10% of residents in the Hospital's service. Posted signs will be clearly visible and legible to patients visiting these areas.","percent_of_total_expense":"The bad debt expense subtracted from total expenses for purposes of calculating the percentage column = 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organization files its annual community benefit report with the Attorney General of Massachusetts as part of the Partners HealthCare System, Inc. Community Benefit Report. http://www.cbsys.ago.state.ma.us/healthcare/hccbar.asp"},{"explanation":"The bad debt expense subtracted from total expenses for purposes of calculating the percentage column = $2,549,000"},{"explanation":"The amounts reported on the charity care and other community benefits table were calculated using the best available data using a cost accounting system or a cost to charge ratio. In most cases, a cost accounting system was used and the system addresses all patient segments and directly assigns costs to individual services."},{"explanation":"The cost of bad debt was calculated using the best available data which included a cost accounting system or a cost to charge ratio. The patient liability is reduced by all payments and insurance contractual adjustments. Previously applied patient discounts are reversed prior to placement in bad debt if the patient does not pay after the prescribed collection process or if the patient reneges on a previously agreed payment schedule."},{"explanation":"In addition to free care and inadequate funding from the Medicaid and Medicare programs, there are significant losses related to self-pay patients who fail to make payment for services rendered or insured patients who fail to remit co-payments and deductibles as required under the applicable health insurance arrangement. The provision of bad debts of $2,549,000 in 2012 and $2,979,000 in 2011 represents charges for services provided that are deemed to be uncollectible. The estimated cost of providing these services was approximately $1,177,279 and $1,212,812 for 2012 and 2011, respectively."},{"explanation":"All costs reported on the Medicare cost report have been determined in accordance with Medicare cost-finding principles. Costs allocable to Medicare patients are limited to certain services and derived in a number of ways, including average cost per day times Medicare days and ratio of cost to charges applied to charges for ancillary services provided to Medicare beneficiaries. The determination of allowable costs via the Medicare cost report excludes the cost and revenue associated with certain services, limits the costs recognized for other services and excludes certain costs of doing business. In addition, the Medicare cost report methodology does not allocate costs to Medicare beneficiaries as precisely as cost accounting systems, which, for example, account for the more intensive nursing care Medicare beneficiaries often require. Taking these factors into account, total revenue received and the full and accurate cost associated with all Medicare services are $17,830,657 and $17,617,912 respectively, resulting in a total Medicare surplus of $212,745."},{"explanation":"The Hospital will take reasonable steps to ensure that no collection actions, including telephone calls, statements or letters, are initiated for those patient balances that may be exempt from collection action by regulation, including patients determined to be Low Income, or enrolled in Mass Health, CMSP, EAEDC, Healthy Start or Center Care excepting those deductibles and co-payments determined by those programs to be a patient responsibility. If it is determined that a patient is in one of those categories then all collection actions (except applicable co-payments and deductibles) with the patient will cease for services occurring during the patient's period of eligibility."},{"explanation":"Martha's Vineyard Hospital is continually evaluating and responding to the health needs of the community on the Vineyard. Needs and priorities are identified through the collection and analysis of data from various sources. Community Partners include: Alzheimer's Services of Cape Cod & the Islands American Red Cross of MV Boston MedFlight Caregivers Homes Continuum of Care Committee (island-wide) Dukes County Health Council DoN Community Health Initiatives Working Group Dukes County Public Health Committee Dukes County Veteran's Agency Elder Affairs Committee Hospice of Martha's Vineyard Island Hospice Martha's Vineyard Association of EMTs Martha's Vineyard Community Services Martha's Vineyard Regional High School Martha's Vineyard Vision Fellowship Martha's Vineyard Whole Health Alliance Municipal Health Officers (six island towns) Network Health Towns of Oak Bluffs, Tisbury & Edgartown Ambulance Services Tri-town Ambulance Service Vineyard Health Care Access Program Visiting Nurse Association Wampanoag Tribe of Gay Head (Aquinnah) Windemere Nursing and Rehabilitation Key Accomplishments of Reporting Year: Completed the process to prepare RFP's to allocate DON funds in October 2010. Initial funding issued in December 2010. Although the process took longer than anticipated, the hospital worked closely with the Department of Public Health, the Dukes County Health Council as well as with the larger community and various stakeholders, over the course of three years to put together the process to disburse the funds. Although the DPH changed its guidelines as well as the focus of the priorities during the process, the hospital continued to work with all groups under the new guidelines on the allocation of funds. The next round of funding will take place in FY13. Patient and Family Council developed operating guidelines and bylaws for the committee. The group then worked with hospital staff on a plan to improve patient flow and wait times in the Emergency Department. Plans for Next Reporting Year: The hospital has the following community benefit initiatives underway for the next reporting year: -Expanding health information internally (brochures and clinical service information)and externally (website) with emphasis on translation for the extensive Brazilian Portuguese community on the Island in an effort to more fully engage this segment of the Vineyard community."},{"explanation":"The Hospital will seek to identify patients who may be uninsured or inadequately insured in order to provide counseling and assistance. The Hospital will provide financial counseling to these patients and their families, including screening for eligibility for other sources of coverage, such as government programs, and providing information regarding all acceptable methods of payment of the Hospital bill. The Hospital will encourage patients who are potentially eligible for coverage by MassHealth, Commonwealth Care, the Health Safety Net, or other government programs to apply for coverage and shall assist the patient in applying for benefits. Patients may also apply for and be approved for coverage by the HSN for co-insurance or other deductibles not covered by their primary insurance plan. The Hospital will post a notice (signs) of the availability of financial assistance programs and describe where to go to for assistance in the following locations: 1. Inpatient, clinic, emergency department, and community health center admission and/or registration areas; 2. Financial Counseling waiting areas 3. Central admission/registration areas that are open to patients 4. Business office waiting areas that are open to patients Signs will be translated into other languages to the extent that the language is the primary language of more than 10% of residents in the Hospital's service. Posted signs will be clearly visible and legible to patients visiting these areas."},{"explanation":"The Martha's Vineyard Hospital (MVH) Board of Trustees approved the following community benefit mission statement on March 14, 1996: Martha's Vineyard Hospital's Community Benefit mission is to strengthen hospital-community partnerships. The hospital continues to develop, in concert with other providers and social service agencies, comprehensive community-based primary and preventive health care programs that come from a needs assessment of major health issues for the people who live on and visit Martha's Vineyard. Martha's Vineyard Hospital (MVH) serves the year-round island community, as well as, visitors to the island. The hospital has long recognized and provided special programs that serve children, women, the elderly, and the underprivileged and will work to expand such programs. MVH will continue to respond to the needs of different cultures as they emerge in our community. Martha's Vineyard Hospital has a tradition of providing services to the uninsured and underinsured. MVH will continue to expend resources for charity care; no one is turned away because of an inability to pay. Recognizing that health care does not simply mean responding to illness, Martha's Vineyard Hospital pledges its resources to help the members of the island community protect themselves from disease and accidents through prevention and wellness programs that include education and screening. Martha's Vineyard Hospital will pursue these goals within the framework of the formal Community Benefits Plan adopted by the Board of Trustees, administration, and staff. This will include a review of the community's health status through an ongoing needs assessment. At all times, the process will include the opportunity for public input and comment. MVH is committed to the continued promotion of cooperative and collaborative relationships with other providers, agencies, schools, and with officials in the various towns that make up the island of Martha's Vineyard."},{"explanation":"Community building activities are described in detail in the organization's community benefit report as filed with the Attorney General of Massachusetts. This report can be accessed at: http://www.cbsys.ago.state.ma.us/healthcare/hccbar.asp In addition, the Hospital's commitment to the environment is demonstrated by the LEED Certification for the new hospital addition which is described at: http://mvhospital.com/about/our-commitment/ Martha's Vineyard Hospital, Inc.'s governing body is comprised of community leaders who are guided by the hospital's mission to deliver excellence in patient care. Surplus funds are used to further the organization's tax exempt missions of patient care. See http://www.mvhospital.com for more information."},{"explanation":"Each of the hospitals that comprise the Partners network has a community benefit planning and service delivery structure. Each of these entities has filed a separate community benefit report. Coordinating activities on a system-wide basis is Matt Fishman, Vice President for Community Health for Partners HealthCare."},{"explanation":"States with which the organization (or a related organization) files a community benefit report: Massachusetts."}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":226680,"reported_domestic_individual_grants":0,"reported_domestic_org_grants_program_services":226680,"total_501c3_and_government_organizations":5,"grants":[{"ein":42301598,"irc_section":"501(c)(3)","cash":51670,"purpose":"Community Benefit Program","address_line1":"111 Edgartown Road","city":"Oak Bluffs","state":"MA","zip":"02557","name":"Martha's Vineyard Community Services","address":"111 Edgartown Road, Oak Bluffs, MA, 02557"},{"ein":222557839,"irc_section":"501(c)(3)","cash":51670,"purpose":"Community Benefit Program","address_line1":"15 Merchants Court","city":"V Haven","state":"MA","zip":"02568","name":"Visiting Nurse Association","address":"15 Merchants Court, V Haven, MA, 02568"},{"ein":46001143,"irc_section":"501(c)(3)","cash":51670,"purpose":"Community Benefit Program","address_line1":"PO Box 5158","city":"Edgartown","state":"MA","zip":"02539","name":"Town of Edgartown","address":"PO Box 5158, Edgartown, MA, 02539"},{"ein":46001255,"irc_section":"501(c)(3)","cash":51670,"purpose":"Community Benefit Program","address_line1":"PO Box 1327","city":"Oak Bluffs","state":"MA","zip":"02557","name":"Town of Oak Bluffs","address":"PO Box 1327, Oak Bluffs, MA, 02557"},{"ein":46001422,"irc_section":"501(c)(3)","cash":10000,"purpose":"Community Benefit Program","address_line1":"PO Box 190","city":"Edgartown","state":"MA","zip":"02539","name":"County of Dukes County","address":"PO Box 190, Edgartown, MA, 02539"}],"total_domestic_grants":226680,"total_domestic_program_services":226680,"detail_org_grants_total":216680,"detail_domestic_grants_total":216680,"supplemental_information":[{"identifier":"Use of Grants/Donations","form_and_line_reference":"Schedule I, Part I, Line 2","explanation":"Martha's Vineyard Hospital, Inc. makes donations to various tax-exempt organiYations, local municipalities and community groups. These donations are made by the Hospital to entities and community groups that share the Hospital's goals and missions."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"Martha's Vineyard Hospital, Inc. makes donations to various tax-exempt organiYations, local municipalities and community groups. These donations are made by the Hospital to entities and community groups that share the Hospital's goals and missions.","form_and_line_reference":"Schedule I, Part I, Line 2"}},"ScheduleF":{"reported_foreign_grants":0},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"form_990_of_other_organizations":true,"written_employment_contract":true,"compensation_survey_or_study":true,"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":false,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"TIMOTHY J 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LENKOWSKI","base_compensation_filing_org":196571,"bonus_filing_org":11700,"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":14282,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":3392,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":3392,"other_compensation_related_orgs":0,"total_compensation_filing_org":229337,"total_compensation_related_orgs":0,"name":"THOMAS LENKOWSKI"}],"supplemental_information":[{"identifier":"Trustee Compensation","form_and_line_reference":"PART II & SCHEDULE J-2","explanation":"TRUSTEES RECEIVE NO COMPENSATION OR CONTRIBUTIONS TO EMPLOYEE BENEFIT PLANS FOR SERVICE ON THE BOARD OR ITS COMMITTEES. BOARD MEMBERS WHO ARE ALSO EMPLOYED BY THE CORPORATION OR A PARTNERS AFFILIATE RECEIVE COMPENSATION ONLY FOR THEIR SERVICES AS EMPLOYEES."},{"identifier":"Establishing CEO Compensation","form_and_line_reference":"Part I, Line 3","explanation":"The Chief Executive Officer's Compensation was established using the following: - Compensation Committee - Independent Compensation Consultant - Form 990 of Other Organizations - Compensation Survey or Study - Approval by the Board or Compensation Committee The Compensation Committee of the Board of Trustees of Martha's Vineyard Hospital makes a recommendation for approval by the Board of Trustees of the Massachusetts General Hospital, an affiliated tax-exempt organization."},{"identifier":"Participation in a supplemental nonqualified retirement plan","form_and_line_reference":"Part I, Line 4B","explanation":"The amount listed below is included in the compensation total reported on Schedule J: Brent L. Henry - $128,079 Andrew L. Warshaw, M.D. - $65,013 Timothy J. Walsh - $18,475 Thomas Lenkowski - $5,850 James Ferriter - $8,850"}]},"ScheduleL":{"business_transactions_involving_interested_persons":[{"person_name":"K Casper MD","relationship":"Pil - family","description":"salary","amount":224238,"sharing_of_revenues":false,"name":"K Casper MD"}]},"ScheduleM":{"policies":{"any_property_that_must_be_held":false,"review_process_unusual_noncash_gifts":true,"third_parties_used":false},"noncash_contributions":{"works_of_art":{"reported":true,"revenue_reported_on_990":50750,"contribution_count":51,"method_of_determining_revenues":"FMV"}}},"ScheduleR":{"tax_exempt_organizations":[{"ein":43230035,"business_name_line1":"Partners HealthCare System Inc (PHS)","primary_activities":"Healthcare","exempt_code_section":"501(c)(3)","public_charity_status":"7","controlled_organization":false,"legal_domicile_state":"MA","direct_controlling_business_name_line1":"NA","address_line1":"Prudential Tower 800 Boylston 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02114"},{"ein":42868893,"business_name_line1":"The MGH Institute of Health Professions","primary_activities":"Med Education","exempt_code_section":"501(c)(3)","public_charity_status":"2","controlled_organization":true,"legal_domicile_state":"MA","direct_controlling_business_name_line1":"MGH","address_line1":"36 First Avenue","city":"Charlestown","state":"MA","zip":"02129","name":"The MGH Institute of Health Professions","address":"36 First Avenue, Charlestown, MA, 02129"},{"ein":204572876,"business_name_line1":"McLean HealthCare Inc (MHC)","primary_activities":"Admin Support","exempt_code_section":"501(c)(3)","public_charity_status":"11a","controlled_organization":true,"legal_domicile_state":"MA","direct_controlling_business_name_line1":"MGH","address_line1":"115 Mill Street","city":"Belmont","state":"MA","zip":"02478","name":"McLean HealthCare Inc (MHC)","address":"115 Mill Street, Belmont, MA, 02478"},{"ein":42697981,"business_name_line1":"The McLean Hospital 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