SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
HARRINGTON MEMORIAL HOSPITAL Inc
 
Employer identification number

04-2103577
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    1,906,466 1,495,596 410,870 0.330 %
b Medicaid (from Worksheet 3, column a) . . . . .     29,381,480 30,247,951 -866,471 0.690 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     3,530,740 4,580,741 -1,050,001 0.840 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     34,818,686 36,324,288 -1,505,602 1.200 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     2,393,995 1,633,008 760,987 0.610 %
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .     1,127,268 905,090 222,178 0.180 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .     3,521,263 2,538,098 983,165 0.790 %
k Total. Add lines 7d and 7j .     38,339,949 38,862,386 -522,437 0.410 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support     4,138   4,138 0 %
4 Environmental improvements            
5 Leadership development and
training for community members		     153,269   153,269 0.120 %
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total     157,407   157,407 0.120 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
1,865,613
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
25,481,113
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
28,488,554
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-3,007,441
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
110 N Main Street
  		Medical Office Space 50 % 0 % 0 %
2Central Mass Compreh
  		Medical Facility 22 % 0 % 0 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Harrington Memorial Hospital
100 South Street
Southbridge,MA015508002 		X X         X   See Sched. O Note  
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
HARRINGTON MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTP://HARRINGTONHOSPITAL.ORG/FOR-PATIENTS/PA
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

Financial Assistance Policy (FAP)
HARRINGTON MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.HARRINGTONHOSPITAL.ORG
b
 
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

HARRINGTON MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19 Yes  
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
PART V, SECTION B, LINE 5: A TOTAL OF THREE FOCUS GROUPS WERE CONDUCTED WITH INDIVIDUALS REPRESENTING THESE POPULATIONS OF INTEREST IN THE HARRINGTON CATCHMENT AREA: (1) SENIOR CITIZENS (OLDER ADULTS), (2) LATINOS, AND (3) SUBSTANCE USERS IN RECOVERY. HARRINGTON LEADERSHIP CHOSE THESE POPULATIONS BASED ON THEIR IDENTIFICATION AS PARTICULARLY VULNERABLE POPULATIONS IN THE HOSPITAL CATCHMENT AREA. THE SENIOR AND RECOVERY GROUPS WERE COMPRISED OF LAY COMMUNITY MEMBERS, WHILE THE LATINO GROUP CONSISTED OF KEY STAKEHOLDERS REPRESENTING COMMUNITY ORGANIZATIONS SERVING THE LATINO POPULATION. REFER TO THE CHNA FOR FURTHER INFORMATION.
PART V, SECTION B, LINE 11: AS NOTED ON ITS WEBSITE, THE HOSPITAL DEVELOPED A STRATEGIC PLAN TO IDENTIFY PROGRAMS AND FUTURE PROJECTS THAT WILL ENABLE THE HOSPITAL TO ADDRESS THE SIGNIFICANT NEEDS IN ITS CHNA.
PART V, SECTION B, LINE 18D: REFERRAL TO COLLECTION AGENCY.
PART V, SECTION B, LINE 19D: COLLECTION AGENCY ACTIVITIES.
PART V, SECTION B, LINE 22D: PATIENT RESPONSIBLE AMOUNTS ARE BASED ON FAMILY SIZE AND RELATIONSHIP OF THE FAMILY'S INCOME TO THE FEDERAL POVERTY GUIDELINES, PER THE HOSPITAL'S UNINSURED RELIEF POLICY. RELIEF IS AVAILABLE FOR INDIVIDUALS WHOSE FAMILY INCOME IS 400% OR LESS OF THE FEDERAL POVERTY GUIDELINES. RELIEF PROVIDED TO THE PATIENT RANGES FROM 100% RELIEF TO 20% RELIEF OF OUTSTANDING AMOUNTS DEPENDING ON FAMILY SIZE AND INCOME LEVEL.
PART V, SECTION B, LINE 24: ALL HOSPITAL PATIENTS ARE CHARGED ACCORDING TO THE HOSPITAL'S ESTABLISHED CHARGES FOR SERVICES. IT IS INCUMBENT UPON THE PATIENT TO AVAIL HIMSELF/HERSELF OF RELIEF THROUGH THE HOSPITAL'S UNINSURED RELIEF PROGRAM.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2015
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Schedule H (Form 990) 2015
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Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART II, COMMUNITY BUILDING ACTIVITIES: AFTER-CARE NURSES & HOME VISITING PROGRAMS FREE-CARE VAN INTERPRETER SERVICES MENTAL HEALTH CLINIC PREVENTIVE HEALTH DEPARTMENT (HEALTH EDUCATION, MAMMOGRAMS, ETC.) PROVISION OF MEETING SPACES FOR RECOVERY COMMUNITY MEETINGS SENIOR CITIZEN LUNCHES VETERANS MEALS VOLUNTEER PROGRAM
PART III, LINE 2: THE ORGANIZATION USED A RATIO OF ITS TOTAL COSTS TO CHARGES APPLIED TO ITS TOTAL BAD DEBT EXPENSE.
PART III, LINE 4: THE ORGANIZATION PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS EQUAL TO ESTIMATED BAD DEBT LOSSES. THE ESTIMATED LOSSES ARE BASED ON HISTORICAL COLLECTION EXPERIENCE TOGETHER WITH A REVIEW OF THE CURRENT STATUS OF EXISTING RECEIVABLES. THE ORGANIZATION USED A RATIO OF ITS TOTAL COSTS TO CHARGES TO CALCULATE THE AMOUNT OF BAD DEBT EXPENSE AT COST.
PART III, LINE 8: THE SHORTFALL EXPERIENCED BY THE ORGANIZATION FROM PROVIDED CARE TO MEDICARE BENEFICIARIES SHOULD BE TREATED AS A COMMUNITY BENEFIT AS IT REPRESENTS THE ORGANIZATION'S CONTRIBUTION TO PROVIDING CARE TO THE FRAIL AND ELDER CITIZENS OF THE COMMUNITY IT SERVES BEYOND THE AMOUNT IT RECEIVES FROM THE MEDICARE PROGRAM. THIS CONTRIBUTION LEVEL IS CONSISTENT WITH THE ORGANIZATION'S OVERALL CHARITABLE MISSION TO PROVIDE CARE TO ALL INDIVIDUALS, REGARDLESS OF THE LEVEL OF PAYMENT RECEIVED FOR PROVIDING THAT CARE. THE ORGANIZATION USED A RATIO OF ITS TOTAL COSTS TO CHARGES TO CALCULATE THE ALLOWANCE COSTS RELATED TO MEDICARE REVENUE RECEIVED.
PART III, LINE 9B: CO-PAYMENT AND/OR DEDUCTIBLE AMOUNTS FOR NON-EMERGENT OR NON-URGENT SERVICES IN ACCORDANCE WITH EMTALA SHALL BE COLLECTED AT TIME OF SERVICES OR REQUESTED BY SENDING A DAY AFTER LETTER. THE FIRST STATEMENT WILL INCLUDE INFORMATION ABOUT THE AVAILABILITY OF A FINANCIAL ASSISTANCE, MEDICAL HARDSHIP, BUDGETS, AND THE HOSPITAL'S UNINSURED RELIEF PROGRAM THAT MIGHT BE ABLE TO COVER THE COST OF THE HOSPITAL'S BILL, ALONG WITH NOTICE OF A PROMPT PAYMENT DISCOUNT FOR UNINSURED PATIENTS OF 20% IF PAID IN FULL WITHIN 10 BUSINESS DAYS OF RECEIVING THE FIRST STATEMENT. A TOTAL OF 3 STATEMENTS AND A FINAL NOTICE LETTER, TELEPHONE CALL ON ALL ACCOUNTS OVER $500.00, COLLECTION LETTERS, PERSONAL CONTACT NOTICES, DAY AFTER LETTER TO COLLECT COPAY AND/OR DEDUCTIBLE AT TIME OF SERVICE, COMPUTER NOTIFICATIONS, OR ANY OTHER NOTIFICATION METHOD THAT CONSTITUTES A GENUINE EFFORT TO CONTACT THE PARTY RESPONSIBLE FOR THE OBLIGATION. DOCUMENTATION OF ALL COLLECTION EFFORTS TO LOCATE THE PARTY RESPONSIBLE FOR THE OBLIGATION OR THE CORRECT ADDRESS ON BILLINGS. SENDING A FINAL NOTICE BY CERTIFIED MAIL FOR UNINSURED PATIENTS (THOSE WHO ARE NOT ENROLLED IN A PUBLIC PROGRAM SUCH AS THE HEALTH SAFETY NET OF MASSHEALTH). THE HOSPITAL SHALL NOT ASSIGN A PATIENT'S ACCOUNTS FOR COLLECTION TO AN OUTSIDE AGENCY PRIOR TO 120 DAYS AFTER THE INITIAL BILL. CHECKING THE ELIGIILITY VERIFICATION SYSTEM (EVS) TO ENSURE THAT THE PATIENT IS NOT A LOW INCOME PATIENT AS DETERMINED BY THE OFFICE OF MEDICAID AND HAS NOT SUBMITTED AN APPLICATION TO THE VIRTUAL GATEWAY SYSTEM FOR COVERAGE OF THE SERVICES UNDER A PUBLIC PROGRAM, PRIOR TO SUBMITTING CLAIMS TO THE HEALTH SAFETY NET OFFICE FOR EMERGENCY BAD DEBT COVERAGE OF AN EMERGENCY LEVEL OR URGENT CARE SERVICE. THE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES BEYOND THE INITIAL BILL PURSUANT TO STATE REGULATIONS: PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO: MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN, "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID SUBJECT TO CERTAIN EXCEPTIONS AS DESCRIBED IN ITS CREDIT AND COLLECTION POLICY.
PART VI, LINE 2: IN NEEDING TO CREATE A NEW HEALTH ASSESSMENT FOR 2011-2013, AN EXTERIOR COMMITTEE WAS FORMED IN 2009 - CONSISTING OF SEVEN MEMBERS, RANGING FROM THOSE IN THE MEDICAL FIELD TO COMMUNITY LIAISONS AND TOWN/LEAGUE REPRESENTATIVES, INCLUDING A CURRENT HARRINGTON HOSPITAL BOARD MEMBER. MEETINGS WERE HELD APPROXIMATELY ONCE PER MONTH FROM JANUARY-DECEMBER 2010, NOT INCLUDING ADDITIONAL EMAIL COMMUNICATION. SURVEY DESIGNED AND IMPLEMENTED IN 2010. COMMITTEE UTILIZED THIRD-PARTY RESOURCES TO ORIGINATE INITIAL DATA ON REGION. 20 QUESTION SURVEY DESIGNED AND DISTRIBUTED TO SEVEN OF THE MAJOR TOWNS HARRINGTON SERVICES. THE SURVEY INCLUDED DEMOGRAPHIC INDICATORS (AGE, INCOME, HOUSEHOLD MEMBERS, ETHNICITY, ZIP CODE OF RESIDENCE, GENDER, EDUCATION LEVEL) AND COMMUNITY HEALTH INDICATORS. MOST QUESTIONS RANKED HEALTH CONDITIONS ON A 1-5 SCALE AND INCLUDED RATING CONDITIONS/ISSUES IN ORDER OF PRIORITY FOR FUNDING, AND A SEPARATE HEALTH CONDITION ANALYSIS FOR YOUTH AND SENIORS. IN 2013, HARRINGTON RECOGNIZED THE NEED TO UPDATE ITS ASSESSMENT DATA AND COMMUNITY INFORMATION FROM THE PREVIOUS STUDY. A FIVE MEMBER COMMITTEE WAS ORGANIZED IN EARLY 2013. THE GROUPS' LEADERSHIP CAME FROM THE HARRINGTON MARKETING DEPARTMENT. MEMBERS REPRESENTED COMMUNITY LIAISONS, HEALTH PROFESSIONALS AND TOWN/LEAGUE REPRESENTATIVES, INCLUDING CURRENT HARRINGTON HOSPITAL BOARD MEMBER. MEETINGS WERE HELD FROM JANUARY TO DECEMBER. THE COMMITTEE ENLISTED THE ASSITANCE OF THE INSTITUE FOR COMMUNITY HEALTH OUT OF BOSTON TO COLLECT, ANALYZE AND PRODUCE A WRITTEN REPORT ON THE HEALTH DEFICITS IN HARRINGTON'S TWENTY ZIP CODE CATCHMENT AREA. THIS ASSESSMENT INVOLVED A MIXED-METHODS APPROACH INCLUDING EXTENSIVE REVIEW OF SECONDARY COMMUNITY DATA SOURCES ACROSS A VARIETY OF SOCIO-DEMOGRAPHIC AND HEALTH INDICATORS FOR THE CATCHMENT AREA COMPARED TO THE STATE OF MASSACHUSETTS, AS WELL AS THREE FOCUS GROUPS WITH A TOTAL OF 24 COMMUNITY RESIDENTS AND KEY STAKEHOLDERS BELONGING TO KEY POPULATIONS OF INTEREST: SENIOR CITIZENS, LATINOS, AND SUBSTANCE USERS IN RECOVERY. FOR SECONDARY DATA GATHERING, TOP HEALTH CONCERNS FOR THE CATCHMENT AREA WERE PRIORITIZED BASED ON THE AVERAGE PERCENT DIFFERENCE COMPARED TO MASSACHUSETTS ACROSS SECONDARY DATA INDICATORS. KEY THEMES IDENTIFIED THROUGH THE THREE FOCUS GROUPS WERE ALSO CONSIDERED. TOP HEALTH CONCERNS THAT EMERGED INCLUDED CARDIOVASCULAR DISEASE/RESPIRATORY HEALTH, DIABETES, OBESITY, CANCER MORTALITY, MENTAL HEALTH, AND TEEN PREGNANCY. ADDITIONAL COMMUNITY-WIDE CONCERNS WERE ALSO IDENTIFIED THROUGH THE THREE FOCUS GROUPS CONDUCTED: CRIME AND SAFETY, ESPECIALLY AMONGST YOUTH; SOCIAL CONCERNS AFFECTING YOUTH, ESPECIALLY LACK OF POSITIVE COMMUNITY ACTIVITIES FOR YOUTH; AND SUBSTANCE ABUSE, INCLUDING PRESCRIPTION DRUG ABUSE AND NEWER DRUG USE AMONGST YOUTH.
PART VI, LINE 3: FOR THOSE PATIENTS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL AND ITS FINANCIAL COUNSELORS WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED PATIENTS FIND AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS AS WELL AS IN GENERAL NOTICES THAT ARE POSTED THROUGHOUT THE HOSPITAL. THE GOAL OF THESE NOTICES IS TO ASSIST PATIENTS IN APPLYING FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM, SUCH AS MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR MEDICAL HARDSHIP THROUGH THE HEALTH SAFETY NET. THE HOSPITAL WILL PROVIDE, UPON REQUEST, SPECIFIC INFORMATION ABOUT THE ELIGIBILITY PROCESS TO BE A LOW INCOME PATIENT UNDER EITHER THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM OR ADDITIONAL ASSISTANCE FOR PATIENTS WHO ARE LOW INCOME THROUGH THE UNINSURED RELIEF PROGRAM. THE HOSPITAL WILL ALSO NOTIFY THE PATIENT ABOUT AVAILABLE PAYMENT PLANS THAT MAY BE AVAILABLE TO THEM BASED ON THEIR FAMILY SIZE AND INCOME. THE HOSPITAL SHALL POST A NOTICE (SIGNS) OF AVAILABILITY OF FINANCIAL ASSISTANCE IN THE FOLLOWING LOCATIONS: I. INPATIENT, CLINIC, AND EMERGENCY DEPARTMENT ADMISSION AND/OR REGISTRATION AREAS; II. PATIENT FINANCIAL COUNSELOR AREAS; III. CENTRAL ADMISSION/REGISTRATION AREAS; AND IV. BUSINESS OFFICE AREAS THAT IS OPEN TO PATIENTS.
PART VI, LINE 4: THE HARRINGTON HEALTHCARE SYSTEM CATCHMENT AREA FOCUSED ON FOR THE ASSESSMENT IS LOCATED PRIMARILY IN THE SOUTHERN REGION OF CENTRAL MASSACHUSETTS, AND INCLUDES 17 MASSACHUSETTS COMMUNITIES (BRIMFIELD, BROOKFIELD, CHARLTON, DOUGLAS, DUDLEY, EAST BROOKFIELD, HOLLAND, NORTH BROOKFIELD, OXFORD, PALMER, SOUTHBRIDGE, SPENCER, STURBRIDGE, WALES, WARREN, WEBSTER, WEST BROOKFIELD) AS WELL AS TWO COMMUNITIES (THOMPSON AND WOODSTOCK) IN NORTHERN CONNECTICUT.
PART VI, LINE 5: REFER TO THE CHNA AND HOSPITAL WEBSITE FOR FURTHER DETAILS.
PART VI, LINE 6: NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.
PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: MA
Schedule H (Form 990) 2015
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