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
2016
Open to Public Inspection
Name of the organization
UMass Memorial Health Care Inc & Affiliates
 
Employer identification number

91-2155626
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) . . . 		    25,236,667 12,741,474 12,495,193 0.64 %
b Medicaid (from Worksheet 3, column a) . . . . .     386,556,879 344,249,564 42,307,315 2.17 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     25,224,257 25,224,257 0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 437,017,803 382,215,295 54,802,508 2.81 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     4,344,967 2,614,831 1,730,136 0.09 %
f Health professions education (from Worksheet 5) . . .     226,973,043 133,907,163 93,065,880 4.78 %
g Subsidized health services (from Worksheet 6) . . . .     88,187,450 69,986,010 18,201,440 0.93 %
h Research (from Worksheet 7) .     153,168 49,850 103,318 0.01 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     2,275,640 2,275,640 0 0 %
j Total. Other Benefits . . 0 0 321,934,268 208,833,494 113,100,774 5.81 %
k Total. Add lines 7d and 7j . 0 0 758,952,071 591,048,789 167,903,282 8.62 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2016
Schedule H (Form 990) 2016
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     7,641 0 7,641 0 %
2 Economic development     0 0 0 0 %
3 Community support     12,994 0 12,994 0 %
4 Environmental improvements     0 0 0 0 %
5 Leadership development and
training for community members		     1,944 0 1,944 0 %
6 Coalition building     4,215 0 4,215 0 %
7 Community health improvement advocacy     0 0 0 0 %
8 Workforce development     69,453 0 69,453 0 %
9 Other     0 0 0 0 %
10 Total 0 0 96,247 0 96,247 0 %
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
44,461,000
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
2,158,840
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
378,034,017
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
428,184,862
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-50,150,845
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 %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2016
Schedule H (Form 990) 2016
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?4Name, 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 UMASS MEMORIAL MEDICAL CENTER INC
55 LAKE AVE 119 BELMONT STREET
WORCESTER,MA01605
www.umassmemorialhealthcare.org
2124, 2841 		X X X X   X X      
2 HEALTHALLIANCE HOSPITAL INC
60 HOSPITAL ROAD
LEOMINSTER,MA01453
www.umassmemorialhealthcare.org/healthalliance-hospital
2127 		X X   X     X      
3 MARLBOROUGH HOSPITAL
157 UNION STREET
MARLBOROUGH,MA01752
www.umassmemorialhealthcare.org/marlborough-hospital
2103 		X X   X     X      
4 CLINTON HOSPITAL ASSOCIATION
201 HIGHLAND STREET
CLINTON,MA01510
www.umassmemorialhealthcare.org/clinton-hospital
2126 		X X   X     X      
Schedule H (Form 990) 2016
Page 4
Schedule H (Form 990) 2016
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
UMASS MEMORIAL MEDICAL CENTER INC
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 14
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 Yes  
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 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.umassmemorialhealthcare.org/sites/umass-memorial-hospital/files/Documents/CB%2520Plan%25
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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) 2016
Page 5
Schedule H (Form 990) 2016
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
UMASS MEMORIAL MEDICAL CENTER INC
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 Was widely publicized 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
https://www.umassmemorialhealthcare.org/umass-memorial-medical-center/patients-visitors
b
https://www.umassmemorialhealthcare.org/umass-memorial-medical-center/patients-visitors
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2016
Page 6
Schedule H (Form 990) 2016
Page 6
Part VFacility Information (continued)

Billing and Collections
UMASS MEMORIAL MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Yes No
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 nonpayment?.................................. 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
f
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   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
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
Schedule H (Form 990) 2016
Page 7
Schedule H (Form 990) 2016
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
UMASS MEMORIAL MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Yes No
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   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2016
Page 4
Schedule H (Form 990) 2016
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
HEALTHALLIANCE HOSPITAL INC
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): 		2
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 15
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 Yes  
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 Yes  
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 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.healthallianceclinton.com
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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) 2016
Page 5
Schedule H (Form 990) 2016
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
HEALTHALLIANCE HOSPITAL INC
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 Was widely publicized 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
https://www.umassmemorialhealthcare.org/healthalliance-clinton-hospital/patients-visitors
b
https://www.umassmemorialhealthcare.org/healthalliance-clinton-hospital/patients-visitors
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2016
Page 6
Schedule H (Form 990) 2016
Page 6
Part VFacility Information (continued)

Billing and Collections
HEALTHALLIANCE HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
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 nonpayment?.................................. 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
f
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   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
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
Schedule H (Form 990) 2016
Page 7
Schedule H (Form 990) 2016
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
HEALTHALLIANCE HOSPITAL INC
Name of hospital facility or letter of facility reporting group  
Yes No
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   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2016
Page 4
Schedule H (Form 990) 2016
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
MARLBOROUGH 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): 		3
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 16
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 Yes  
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 Yes  
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 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.umassmemorialhealthcare.org/about-us/community-benefits-program/marlborough-
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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) 2016
Page 5
Schedule H (Form 990) 2016
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
MARLBOROUGH 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 Was widely publicized 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
https://www.umassmemorialhealthcare.org/marlborough-hospital/patients-visitors/patient-resources
b
https://www.umassmemorialhealthcare.org/marlborough-hospital/patients-visitors/patient-resources
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2016
Page 6
Schedule H (Form 990) 2016
Page 6
Part VFacility Information (continued)

Billing and Collections
MARLBOROUGH HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
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 nonpayment?.................................. 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
f
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   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
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
Schedule H (Form 990) 2016
Page 7
Schedule H (Form 990) 2016
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
MARLBOROUGH HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
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   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2016
Page 4
Schedule H (Form 990) 2016
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
CLINTON HOSPITAL ASSOCIATION
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): 		4
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 14
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 Yes  
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 Yes  
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 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.umassmemorialhealthcare.org/healthalliance-clinton-hospital
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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) 2016
Page 5
Schedule H (Form 990) 2016
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
CLINTON HOSPITAL ASSOCIATION
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 Was widely publicized 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
https://www.umassmemorialhealthcare.org/healthalliance-clinton-hospital/patients-visitors
b
https://www.umassmemorialhealthcare.org/healthalliance-clinton-hospital/patients-visitors
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2016
Page 6
Schedule H (Form 990) 2016
Page 6
Part VFacility Information (continued)

Billing and Collections
CLINTON HOSPITAL ASSOCIATION
Name of hospital facility or letter of facility reporting group  
Yes No
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 nonpayment?.................................. 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
f
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   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
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
Schedule H (Form 990) 2016
Page 7
Schedule H (Form 990) 2016
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
CLINTON HOSPITAL ASSOCIATION
Name of hospital facility or letter of facility reporting group  
Yes No
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   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2016
Page 8
Schedule H (Form 990) 2016
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - UMass Memorial Medical Center. The most recent CHNA also includes an Impact Evaluation Summary (final Appendix) of previous CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - UMass Memorial Medical Center. Yes, input from diverse persons who represent the community was taken into account. UMass Memorial Medical Center joined efforts with the Worcester Division of Public Health (WDPH), Fallon Health and Common Pathways, a Healthy Communities Coalition that is comprised of 30+ health and human service organizations, in the development of its Community Health Needs Assessment (CHNA). The Director of the WDPH, UMass Memorial Vice President of Community Relations, and Fallon Health co-chaired the leadership process to develop a CHNA and Community Health Improvement Plan (CHIP) for the greater Worcester region. During the assessment process, community members were engaged in Key Informant Interviews, Focus Groups, and Community Dialogues, which allowed for community members to review and discuss a profile of the region and provide their feedback on community health-related strengths, needs, and a vision for the future. Ten community dialogue sessions were held: five sessions in Worcester, and five in the outlying communities (one each in Shrewsbury, Grafton, Millbury, West Boylston, Leicester, and Holden). More than a total of 1,777 individuals (including participants in an online community survey) representing diverse institutions and community organizations from across the region worked together to establish a roadmap for the future health of the region. The process included a Steering Committee comprised of a diverse number of stakeholders that advised and informed the CHNA.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - UMass Memorial Medical Center. UMass Memorial conducted the CHNA in collaboration with the Worcester Division of Public Health and Fallon Health. Additional partners included: American Cancer Society Central MA Tobacco Free Community Partnership Clark University Mosakowski Institute for Public Enterprise College of the Holy Cross Community Harvest Project Edward M. Kennedy Health Center Edward Street Child Services Family Health Center of Worcester Health Foundation of Central MA March of Dimes Massachusetts Department of Public Health Regional Environmental Council of Worcester Reliant Medical Group South East Asian Coalition UMass Graduate School of Nursing UMass Medical School United Way of Central MA WalkBike Worcester Worcester City Council District-4 Worcester Food Policy Council Worcester Police Department Worcester Public Schools Worcester Regional Research Bureau Worcester Senior Center Worcester Tree Initiative YWCA of Central MA
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - UMass Memorial Medical Center. The CHNA was publicly announced to the community at an event attended by more than 100 community stakeholders and hosted by the Worcester City Manager, Worcester Director of Public Health, Senior Vice President of UMass Memorial Health Care, President of the UMass Memorial Health Care Hospitals and the UMass Memorial Vice President of Community Relations. The hospital and WDPH also engaged in various media venues including; print and online articles in local news and community newspapers, CHNA-8, a Healthy Communities Coalition and interviews televised on WCCATV13.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - UMass Memorial Medical Center. The hospital conducted its most recent Community Health Needs Assessment in tax year 2014 and developed its implementation strategy. The Board of Trustees approved the Community Health Needs Assessment on the last day of the tax year 2014 and implementation strategies were developed and approved in tax year 2015. The prioritization process was lead by the Worcester Division of Public Health, Fallon Health and the hospital Vice President of Community Benefits and included input from approximately 100 community stakeholders. This process resulted in the development of the 2016 Greater Worcester Community Health Improvement Plan (CHIP). The hospital's Community Benefit Implementation Strategy has alignment with the CHIP. The other needs that are not included in the CHNA/CHIP are not being addressed because they are not a part of the identified priority CHIP Domain areas and due to limited funding.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - UMass Memorial Medical Center. Financial Assistance - UMassMemorial Medical Center employs a staff of Financial Counselors, Certified Application Counselors, Customer Service Representatives and Guarantor Collectors who are available by phone or by appointment to support patients in applying for financial assistance and resolving their medical bills. Financial Counselors, Certified Application Counselors, Customer Service Representatives and Guarantor Collectors provide potentially eligible patients with the appropriate methods of applying for health care coverage as listed on the Massachusetts ConnectorCare website
Schedule H, Part V, Section B, Line 16 Facility , 2 Facility , 2 - UMASS MEMORIAL MEDICAL CENTER. Sch H, Part V, Section B, Lines 16 a-c Website for FAP, its application, and its plain language summary: https://www.umassmemorialhealthcare.org/umass-memorial-medical-center/patients-visitors/patient-resources/financial-assistance
Schedule H, Part V, Section B, Line 19d Facility , 1 Facility , 1 - UMass Memorial Medical Center. UMMMC refers accounts to a credit agency when written off as bad debt for further collections. These agencies continue collections without impact to the credit rating.
Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. The Community Health Assessment process consisted of a comprehensive gathering of quantitative (i.e., health status indicators) and qualitative data, through focus groups with community members and through interviews with community members and community leaders. Participants were drawn from among community-based, educational, civic, governmental, and faith-based professionals, health care providers, and others, and every effort was made to ensure racial/ethnic, socioeconomic, and geographic diversity in the composition of focus groups and interview participants. HealthAlliance Hospital collaborated with the Joint Coalition on Health (JCOH) and Heywood Hospital to conduct a comprehensive Community Health Assessment that gathered, analyzed and documented qualitative and quantitative data.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. The Community Health Assessment process consisted of a comprehensive gathering of quantitative (i.e., health status indicators) and qualitative data, through focus groups with community members and through interviews with community members and community leaders. Quantitative data for this study were obtained from many of the same resources used in prior assessments, including MassCHIP data obtained by individual request and configured manually in collaboration with MA DPH; the Youth Risk Behavior Survey (YRBS) data; U.S. Census data; and other authoritative data sources (e.g., state and federal governmental organizations or agencies) subject to rigorous review and data verification processes. Qualitative data were gathered through 16 Focus Groups with 228 participants and 26 Key Informant interviews with individuals representing diverse communities and populations of North Central Massachusetts. Participants were drawn from among community-based, educational, civic, governmental, and faith-based professionals, health care providers, and others, and every effort was made to ensure racial/ethnic, socioeconomic, and geographic diversity in the composition of focus groups and interview participants. HealthAlliance Healthcare collaborated with the Joint Coalition on Health (JCOH) and Heywood Hospital to conduct a comprehensive Community Health Assessment that gathered, analyzed and documented qualitative and quantitative data. Participants involved in the Community Health Needs Assessment were drawn from among community-based, educational, civic, governmental, and faith-based professionals, health care providers, and others, and every effort was made to ensure racial/ethnic, socioeconomic, and geographic diversity in the composition of focus groups and interview participants. Participants were gathered via the newspaper, our website, social media posts inviting them to the focus group and flyers were posted at individual organizations.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. HealthAlliance Hospital conducted a Community Health Needs Assessment with Heywood Healthcare (Heywood Hospital and Athol Hospital)
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. The Community Health Needs Assessment was conducted with input from our community partners: Community Health Connections, Heywood Healthcare (Athol Hospital, Heywood Hospital), The Joint Coalition on Health and the Montachusett Public Health Network
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. Community Health Assessment was made available through our website and presentations to various organizations and community forums throughout our service areas. The Community Health Assessment is also available upon request. You can find the link to our Community Health Needs Assessment here: https://www.umassmemorialhealthcare.org/about-us/community-benefits-program/healthalliance-clinton-hospital-community-benefits-program
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance Hospital. The hospital responds to priority health needs in many ways, and in times that are critical for patients in crisis. In addition to charity care, indigent care, a significant number of programs and services offered address some of the priority needs identified in the CHNA. Our hospital does not have the available resources to develop initiatives to meet all identified health needs, which makes collaboration with community resources critical.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - HealthAlliance Hospital. HealthAlliance Hospital Patients who are scheduled to be admitted and have been identified as non insured and/or in need of financial assistance will have an appointment scheduled prior to admission to meet with a Financial Counselor. Patients, who are admitted to the hospital through the Emergency Department, will be visited by the Financial Counselor once the patient is on the inpatient floor. The meeting will be held with the patient and/or family as the patient's medical condition permits.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Marlborough Hospital. The process included gathering community input through a Community Health Survey to community members, as well as analysis of general data collected from the hospital and publicly available data sources. The process also incorporated a survey component that was available in English, Spanish and Portuguese, as well as 607 respondents in 22 metro west region communities completed a community survey and 150 individuals from multi sector organizations, community stakeholders and residents were engaged in focus groups.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Marlborough Hospital. The CHNA was completed in conjunction with the MetroWest Medical Center.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Marlborough Hospital. The CHNA was completed in conjunction with MetroWest Health Foundation, MetroWest Medical Center, Hudson Health Department, and Framingham Health Department.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Marlborough Hospital. The hospital responds to priority health needs in many ways, and in times that are critical for patients in crisis. In addition to charity care, indigent care, a significant number of programs and services offered address the priority needs identified in the Community Health Needs Assessment (CHNA). Our hospital does not have the available resources to develop initiatives to meet every priority health need identified, which makes collaboration with community agencies critical. The hospital is not currently addressing all chronic conditions due to limited resources.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Marlborough Hospital. Financial Assistance - Marlborough Hospital employs Financial Counselors who are available by phone or by appointment to support patients in applying for financial assistance and for help resolving their medical bills. Financial Counselors provide potentially eligible patients with the appropriate methods of applying for health care coverage as listed on the Massachusetts ConnectorCare website.
Schedule H, Part V, Section B, Line 19d Facility , 1 Facility , 1 - Marlborough Hospital. Marlborough engages a third party agency to assist on all self pay accounts at origination. They refer accounts to a credit agency when written off as bad debt for further collections. These agencies continue collections without impact to the credit rating.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Clinton Hospital. Clinton Hospital collaborates with the Community Health Network Area 9 (CHNA 9); a local coalition of public, Montachusett Public Health Network (MPHN), other key stakeholders in health improvement, residents living within the hospital's catchment area, coalitions that address health needs of vulnerable populations, communities of faith, businesses, and providers of community-based health, education, human services and the local and state legislature when conducting it's Community Health Needs Assessment. The hospital responds to identified community needs and addresses them among our most vulnerable, medically underserved populations. Clinton hospital's target populations for Community Benefits initiatives are identified through a community input, focus groups, informant stakeholder interviews, planning process, collaborative efforts, and a Community Health Needs Assessment (CHNA) which is conducted every three years. Clinton hospital took into account input from the health assessments, representatives of the community, including diverse members who were interviewed in the Community Health Assessment Focus groups. Clinton Hospital utilized the information in the CHNA to collaborate with other community based organizations to adopt implementation strategies that address the unmet health needs of Clinton Hospital's catchment area. The CHNA is guided by members of an Community Benefits Advisory Committee that provides input and assures all necessary data, analysis and report components are included. The hospital works with their partners to collate data from multiple sources, put into conversation identified demographic data, quantitative health data, and qualitative data on community themes and strengths, including input gathered through 13 focus groups attended by a total of 90 people, public forums, and 73 key informant stakeholder interviews.
Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Clinton Hospital. Clinton Hospital collaborated with two other hospitals in conducting the Community Health Assessment of North Central Massachusetts in a joint effort between the Massachusetts Department of Public Health's Community Health Network Area of North Central Massachusetts (CHNA 9) and the Joint Coalition on Health (JCOH) assessment. They include HealthAlliance Hospital, an affiliate of UMass Memorial Health Care and Heywood Hospital.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Clinton Hospital. Clinton Hospital conducted the CHNA with the following listed organizations: Partners included: The Community Health Network Area of North Central Mass. (CHNA 9) The Joint Coalition on Health of North Central Massachusetts. The Minority Coalition of North Central Massachusetts. The qualitative work was completed with the combined efforts of the Minority Coalition of North Central Massachusetts, the Spanish American Center, Cleghorn Neighborhood Center, Heywood Hospital, HealthAlliance Hospital, WHEAT, Three Pyramids, Beautiful Gate Church, New Hope Community Church, Twin Cities CDC, Gardner CDC, Memorial Congregational Church, Montachusett Opportunity Council and many other agencies and individuals.
Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - Clinton Hospital. Clinton Hospital also presents the Community health assessment to community groups, community advisory committee, and to the hospital's Board of Trustees.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Clinton Hospital. Clinton Hospital's Community Benefits Program strives to meet the Schedule H/Form 990 IRS mandate to promote health for a class of persons sufficiently large so the community as a whole benefits. Our programs mirror the five core principles outlined by the Public Health Institute in terms of the emphasis on communities with disproportionate unmet health-related needs; emphasis on primary prevention; building a seamless continuum of care; building community capacity; and collaborative governance. In addition to charity care, indigent care, several initiatives and services offered that addresses some of the priority needs identified in the CHNA for example Mental health, Access to Health care and Food Security/Hunger/ Healthy Weight. Our hospital does not have the available resources to develop initiatives to meet every priority health need identified, which makes collaboration with community partners significant.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Clinton Hospital. Financial Assistance - Clinton Hospital employs a staff of Financial Counselors, Certified Application Counselors, Customer Service Representatives and Guarantor Collectors who are available by phone or by appointment to support patients in applying for financial assistance and resolving their medical bills. Financial Counselors, Certified Application Counselors, Customer Service Representatives and Guarantor Collectors provide potentially eligible patients with the appropriate methods of applying for health care coverage as listed on the Massachusetts ConnectorCare website.
Schedule H, Part V, Section B, Line 16 Facility , 2 Facility , 2 - CLINTON HOSPITAL. Sch H, Part V, Section B, Lines 16 a-c Website for FAP, its application, and its plain language summary: https://www.umassmemorialhealthcare.org/clinton-hospital/patients-visitors/patient-resources/financial-counseling
Schedule H, Part V, Section B, Line 19d Facility , 1 Facility , 1 - Clinton Hospital. Clinton refers accounts to a credit agency when written off as bad debt for further collections. These agencies continue collections without impact to the credit rating.
Schedule H (Form 990) 2016
Page 9
Schedule H (Form 990) 2016
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?4
Name and address Type of Facility (describe)
1 UMASS MEMORIAL MED CENTER (LAB SVCS)
BIOTECH ONE 365 PLANTATION STREET
WORCESTER,MA01605 		SATELLITE - LAB SERVICES
2 UMASS MEMORIAL MED CENTER (PATHOLOGY)
BIOTECH THREE ONE INNOVATION DRIVE
WORCESTER,MA01605 		SATELLITE - PATHOLOGY
3 UMASS MEMORIAL MED CENTER AMBULANCE
23 WELLS STREET
WORCESTER,MA01604 		SATELLITE - AMBULATORY SERVICES
4 UMASS MEMORIAL MED CENTER
100 PROVIDENCE STREET
WORCESTER,MA01604 		SATELLITE - AMBULATORY SERVICES
5
6
7
8
9
10
Schedule H (Form 990) 2016
Page 10
Schedule H (Form 990) 2016
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Schedule H, Part I RESEARCH EXPENSES THE AMOUNT OF RESEARCH EXPENSES FOR FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS BEING REPORTED BY UMASS MEMORIAL HEALTH CARE IS LOW SINCE THESE COSTS ARE SUPPORTED BY THE UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL. THE MEDICAL SCHOOL IS CLOSELY ASSOCIATED WITH UMASS MEMORIAL HEALTH CARE AND PROVIDES A SIGNIFICANT NUMBER OF COMMUNITY BASED PROGRAMS.
Schedule H, Part II, Line 2 COMMUNITY BUILDING ACTIVITIES Part II Community Building: Community Building - Describe how the organization's community building activities, as reported in Part II promote the health of the communities the organization serves: Clinton Hospital's Community Benefits Program strives to meet the Schedule H/Form 990 IRS mandate to promote health for a class of persons sufficiently large so the community as a whole benefits. Our programs mirror the five core principles outlined by the Public Health Institute in terms of the emphasis on communities with disproportionate unmet health-related needs; emphasis on primary prevention; building a seamless continuum of care; building community capacity; and collaborative governance. In addition to charity care, indigent care, several initiatives and services offered that addresses some of the priority needs identified in the CHNA for example Mental health, Access to Health care and Food Security/Hunger/ Healthy Weight. Our hospital does not have the available resources to develop initiatives to meet every priority health need identified, which makes collaboration with community partners significant. HealthAlliance: For Workforce Development HealthAlliance has provided financial assistance to students who wish to pursue a career in the health care field via an internship program providing financial assistance and experience through hand on practice and observation. For Community Support, Community emergency preparedness and drills are conducted in collaboration with the Leominster and Fitchburg Fire Departments and local EMS. Marlborough Hospital: Marlborough Hospital provides assistance to cognitively challenged post grad students aged 18 to 22 by helping them gain work/life skills to assist them in their transition from a school environment to a work and community setting. Additionally, disadvantaged students, including both economically or disengaged youth at risk, learn the tools to overcome barriers and move into self sustaining employment in sectors of the economy where there is a need. Clinton Hospital: Clinton Hospital is working to address basic, social and personal needs as a way to improve their communities' health. During FY 2017 Clinton Hospital provided seven high school students with the opportunity of a health career preparation program. The program exposed these students to health career possibilities, role models and how health organizations operate; it is also an opportunity for practical experience to learn by doing and applying the knowledge. The students learn new skills and develop their own personal and professional interests. They also expand their educational opportunities, personal network and make connections. This program was developed and implemented in response to an identified need in the community. Workforce Development is identified as a need nationally, as a critical component to social determinants of health, and in its community health needs assessment. Clinton Hospital partnered with the Clinton Public High School and the Workforce Investment Board to implement the program.
Schedule H, Part VI, Line 7 SCH H, PART VI, LINE 7 ALL FOUR HOSPITAL'S FILE INDIVIDUAL COMMUNITY BENEFIT REPORTS WITH THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE.
Schedule H, Part III, Line 8 Schedule H, Part III, Line 8 UMASS BELIEVES THERE ARE SEVERAL REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. FIRST, NON-NEGOTIABLE MEDICARE RATES ARE SOMETIMES OUT-OF-LINE WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS. SECOND, BY CONTINUING TO TREAT PATIENTS ELIGIBLE FOR MEDICARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES. THIRD, IRS REVENUE RULING 69-545 STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.
Schedule H, Part I, Line 7g Subsidized Health Services NOT APPLICABLE
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 0
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The Cost to Charge Ratio is utilized to calculate amounts reported for each line in Part 1, Line 7
Schedule H, Part II Community Building Activities UMass Memorial Healthcare recognizes Community Building activities as being a part of the "social determinants of health" that impact the health of the community. We invest in youth workforce development for at-risk youth. Programs are based on our Community Benefits Mission which was recommended by a Community Benefits Advisory Committee and draws inspiration from the World Health Organization's broad definition of health, as a "as state of complete, physical, mental and social well-being and not merely the absence of disease." By adopting this definition, UMass Memorial Medical Center has expanded its strategy to include the social and economic obstacles that prevent people from achieving optimal health. All of our Community Building activities are the result of an identified need and engage the community. They include collaborative efforts, advocacy activities and partnerships that engage a broad array of community stakeholders in addressing these unmet social determinants of health. Community Building activity examples include: Funding and promoting workforce and health career development opportunities for inner-city youth. The hospital additionally provides community support through efforts including participation in the United Way Day of Caring and others. The hospital's Center for Innovation and Transformational Change (CITC) also provided Lean Management/ Process Improvement training to the City of Worcester Cabinet Leadership team.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Bad Debt is calculated utilizing an aged Bad Debt Model. Significant Analysis was reviewed by Revenue Reporting and Patient Accounting that verified the majority of what the Model considers Bad Debt will more than likely be written off as Admin Allowances. Based on the Meditech/Soarian/Ambulance Variance Summary output per payer and review of the other analysis prepared, it was determined and approved that the Provision as a result of the Model should represent only the following reserves: 1) Self Pay 2) FreeCare 3) Guarantor As such, the remaining reserves calculated on all other payers are included in Payment Systems Contractual reserves and Admin Allowance reserves. Bad Debt Recoveries (payments on accounts written off as Bad Debt) are recorded on the Financial statements as a reduction to Bad Debt Expense. Bad Debt Expense of 44,461,000 is net of these recoveries.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology Costing methodology: multiplied the gross patient service revenue by the ratio of costs to charges calculated as reported in hospitals DHCFP 403 Hospital Statement of Costs, Revenues & Statistics. Although our financial assistance policies and procedures make every effort to identify those patients who are eligible for financial assistance before the billing process begins, often it is not possible to make an appropriate determination until after the billing and collection collection cycle has commenced. The rationale for including bad debt amounts in community benefits would be to account for those patients who were classified as bad debt expense, but would have qualified for financial assistance if sufficient information had been available to make a determination of their eligibility.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Footnote 2, page 10 of Audited Financial Statements: Allowance for Doubtful Accounts Patient accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of patient accounts receivable, the System analyzes its past history and identifies trends for each of its major categories of revenue (inpatient, outpatient and professional) to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major categories of revenue in evaluating the sufficiency of the allowance for doubtful accounts. Throughout the year, the System, after all reasonable collection efforts have been exhausted, will write off the difference between the standard rates (or discounted rates if negotiated) and the amounts actually collected against the allowance for doubtful accounts. In addition to the review of the categories of revenue, management monitors the write offs against established allowances as of a point in time to determine the appropriateness of the underlying assumptions used in estimating the allowance for doubtful accounts. Patient accounts receivable is presented net of an allowance for doubtful accounts of $57,869,000 and $50,834,000 as of September 30, 2017 and 2016, respectively, in the consolidated balance sheets. Management attributes this change in the allowance for doubtful accounts due to a decrease in accounts receivable and improvement in the aging where more current accounts are reflected in the current year. Bad debt expense for nonpatient related accounts receivable is reflected in operating expense on the statements of operations. Patient related bad debt expense is reflected as a reduction in patient service revenue in the statements of operations
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE MEDICARE COSTS ARE OBTAINED FROM THE COST REPORT FOR INPATIENT PSYCHIATRIC CAPITAL AND OUTPATIENT SERVICES. IN ADDITION, FEE BASED SERVICES, SUCH AS LABS, PT, OT, ETC, ARE DETERMINED THROUGH PS&R CHARGES TIMES OUTPATIENT COST TO CHARGE RATIO.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance A. Exemption From Self-Pay Billing and Collection Action- UMMHC will not initiate Self-Pay billing and collection activity in the following instances: 1. Upon sufficient proof that a patient is a recipient of Emergency Aid to the Elderly, Disabled and Children (EAEDC), or enrolled in MassHealth, Health Safety Net, the Children's Medical Security Plan whose family income is equal or less than 300% of the FPL or Low Income Patient designation with the exception of Dental-Only Low Income patients as determined by the office of Medicaid with the exception of co-pays and deductibles required under the Program of Assistance. 2. The hospital has placed the account in legal or administrative hold status and/or specific payment arrangements have been made with the patient or guarantor. 3. Medical Hardship bills that exceed the medical hardship contribution. 4. Medical Hardship contributions that remains outstanding during a patient's MassHealth or Low Income Patient eligibility period. 5. Unless UMMHC has checked the EVS system to determine if the patient has filed an application for MassHealth. 6. For Partial Health Safety Net eligible patients, with the exception of any deductibles required. 7. UMMHC may bill for Health Safety Net eligible and Medical Hardship patients for non-medically necessary services provided at the request of the patient and for which the patient has agreed by written consent. 8. UMMHC may bill a Low Income Patient at their request in order to allow the patient to meet the required CommonHealth One-Time Deductible
Schedule H, Part V, Section B, Line 16a FAP website - UMASS MEMORIAL MEDICAL CENTER, INC: Line 16a URL: https://www.umassmemorialhealthcare.org/umass-memorial-medical-center/patients-visitors; - HEALTHALLIANCE HOSPITAL, INC: Line 16a URL: https://www.umassmemorialhealthcare.org/healthalliance-clinton-hospital/patients-visitors; - MARLBOROUGH HOSPITAL: Line 16a URL: https://www.umassmemorialhealthcare.org/marlborough-hospital/patients-visitors/patient-resources; - CLINTON HOSPITAL ASSOCIATION: Line 16a URL: https://www.umassmemorialhealthcare.org/healthalliance-clinton-hospital/patients-visitors;
Schedule H, Part V, Section B, Line 16b FAP Application website - UMASS MEMORIAL MEDICAL CENTER, INC: Line 16b URL: https://www.umassmemorialhealthcare.org/umass-memorial-medical-center/patients-visitors; - HEALTHALLIANCE HOSPITAL, INC: Line 16b URL: https://www.umassmemorialhealthcare.org/healthalliance-clinton-hospital/patients-visitors; - MARLBOROUGH HOSPITAL: Line 16b URL: https://www.umassmemorialhealthcare.org/marlborough-hospital/patients-visitors/patient-resources; - CLINTON HOSPITAL ASSOCIATION: Line 16b URL: https://www.umassmemorialhealthcare.org/healthalliance-clinton-hospital/patients-visitors;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - UMASS MEMORIAL MEDICAL CENTER, INC: Line 16c URL: https://www.umassmemorialhealthcare.org/umass-memorial-medical-center/patients-visitors; - HEALTHALLIANCE HOSPITAL, INC: Line 16c URL: https://www.umassmemorialhealthcare.org/healthalliance-clinton-hospital/patients-visitors; - MARLBOROUGH HOSPITAL: Line 16c URL: https://www.umassmemorialhealthcare.org/marlborough-hospital/patients-visitors/patient-resources; - CLINTON HOSPITAL ASSOCIATION: Line 16c URL: https://www.umassmemorialhealthcare.org/healthalliance-clinton-hospital/patients-visitors;
Schedule H, Part VI, Line 2 Needs assessment In addition to conducting the Community Health Needs Assessment (CHNA), UMass Memorial Medical Center assesses the health care needs of the community it serves by working closely with the Worcester Division of Public Health on an on-going basis. Community Benefits staff hold leadership roles and/or participate in multiple coalitions and efforts focused on addressing priority areas identified in the CHNA and aligned with strategies of the Community Health Improvement Plan. In 2016 and 2017, the Vice President of Community Relations co-led the establishment and continued development of the Coalition for a Healthy Greater Worcester, a healthy communities coalition that coordinates and provides accountability for CHIP Priority Area Working Groups and includes a subcommittee for oversight of Determination of Needs (DoN) funds distribution. The hospital also works closely with the Worcester Free Clinics Coalition, the Worcester Public Schools and two community health centers (Family Health Center of Worcester and the Edward M. Kennedy Community Health Center) on an ongoing basis through its Ronald McDonald Care Mobile program and Prevention and the Worcester Pediatric Asthma Task Force/Intervention. UMass Memorial Medical Center completed its CHNA by assembling a diverse group of community stakeholders that include, but are not limited to, members of health and human service organizations, philanthropy, communities of color, neighborhood residents and the Worcester Division of Public Health as part of the group that assisted and guided the assessment process. The hospital's Community Benefit Implementation Strategy is aligned with the CHIP. The other needs that are not included in the CHNA/CHIP are not being addressed because they are not a part of the nine identified priority CHIP Domain areas and due to limited funding. The following strategies were conducted to complete the assessment: * Conducted key informant interviews and focus groups with community-based organizations and residents * Conducted outreach efforts to medically-underserved populations and convene meetings with neighborhood/community groups * Reviewed primary and secondary data * Conducted online community survey * Organized community forums to share findings and release of final report * Organized task forces for further action to identify priority areas The following sources inform and enhance our efforts to identify priorities and unmet needs: * U.S. Census 2010 * U.S. Census American Fact Finder * Healthy People 2020 * National Prevention Strategy * Massachusetts Department of Education Reports including local enrollment and language data * Massachusetts Department of Employment and Training * Hospital utilization data * Massachusetts Department of Public Health/ MassCHIP * Data from various City of Worcester departments including, but not limited to, the local Division of Public Health, Neighborhood Services and Police. * Information collected from health care providers, community groups/underserved populations and individuals who have expertise on community health issues. HealthAlliance: UMass Memorial- HealthAlliance Hospital works with a range of community based organizations including Fitchburg and Leominster Public Schools, Montachusett Opportunity Council, Community Health Network of North Central Massachusetts (CHNA 9) and many other local partners/organizations. We work closely with the CHNA9 to create and implement a Community Health Improvement Plan (CHIP). UMass Memorial - HealthAlliance Hospital co-chairs the Mental/Behavioral Health and Substance Committee. The goal of this committee is to improve overall behavioral health and well-being, including preventing substance abuse, in a culturally diverse, responsive, and holistic manner. During FY17, a survey was developed to establish a baseline for the knowledge and understanding of gaps to accessing mental health services for youth and adults in North Central, MA. Marlborough Hospital: The CHNA is comprised of qualitative and quantitative data collected through a community engagement process. In addition, the Community Benefits Advisory Council, comprised of members of different agencies and businesses in the area, helps to identify programs in support of the community priorities. In addition to conducting the CHNA, Marlborough Hospital assesses the health care needs of the community it serves by working closely with its Community Benefits Advisory Committee (CBAC). The CBAC, is chaired by the president of the Boys and Girls Club of Metrowest who is also a hospital trustee. Other CBAC members include representatives from the Hudson and Marlborough Public Schools and the Boards of Health, agencies that focus on addiction and recovery services, the Council on Aging, the Marlborough Community Development Corporation, Wellness Council members and residents of the community. The CBAC helps to identify programs in support of the community priorities, provides feedback on an on-going basis and focuses on addressing priority areas identified in the CHNA and aligned with strategies of the Community Health Improvement Plan. Clinton Hospital: The hospital engages in other efforts to assess the needs of the community such as; planning and collaborative efforts that include the North Region's Community Health Improvement Plan Healthy Living Priority Area, active involvement with the Minority Coalition Health Disparities and Racial Justice priority area and leadership in the Clinton Community Partnership, whose mission is to coordinate resources in order to provide full access to programs that support lifelong education, health, career advancement, job placement and economic development for members of our communities. The hospital's Community Benefits Manager co-chairs the Clinton Area Community Partnership and collaborates with WHEAT Community Connections related to implementing community initiatives that focus on the health needs of the underserved populations served through their food pantry and serves on several local committees including Department of Public Health's Community Health Network Association 9 Steering Committee.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Financial Counselors, also referred to as Certified Application Counselors (CAC's) are state certified and located on all campus locations. CAC's are available to assist underinsured and uninsured patients navigate the medical benefit application process. CAC's will take the steps necessary to help patients submit applications to obtain coverage, resolve eligibility issues, upgrade their coverage to coverage that provides more benefits, choose and enroll in a MassHealth or Connector Care Health insurance plan and change these plans when necessary.
Schedule H, Part VI, Line 4 Community information Geographical Reach: The 2015 Community Health Assessment (CHNA) and subsequent Greater Worcester Community Health Improvement Plan (CHIP) focuses on the City of Worcester and the outlying communities of Shrewsbury, Millbury, West Boylston, Leicester, Grafton and Holden, a sub-section of its primary service area. This specific geographic area is the focus for the City of Worcester Division of Public Health regionalization initiative, and overlaps with the service area of many other local organizations. Focusing UMass Memorial's CHNA on this geographic area facilitates the alignment of the hospital's efforts with community and governmental partners, specifically the city health department, the area Federally Qualified Health Centers, and community-based organizations. This focus also facilitates collaboration with the CHIP Advisory Committee that implements key strategies of the CHIP so that future initiatives can be developed in a more coordinated approach. Regional Description: The City of Worcester is very ethnically-diverse, considerably more so than the nation and state overall. The number of Hispanics living in the city has grown by 35% over the past 10 years. Refugees from Iraq currently account for the greatest percentage of new immigrants (51%) followed by refugees from Bhutan, Burma, Liberia and other African nations. Health Resources and Services Administration (HRSA) has designated the City of Worcester a health professional shortage area (HPSA) in primary care, mental health and dental services due to its low income population. The City of Worcester has several neighborhoods with a shortage of health providers and HRSA has determined that many census tracts in the city are medically-underserved areas (MUAs). Economic Characteristics: The U.S. Census population estimates for 2012-2016 indicated that the median household income for the Worcester County region was $67,005. For the City of Worcester, the region's largest urban area, the estimate for this period was considerably lower at $45,599. According to the census data, of the city's total 184,508 residents, 22.1% are living below the poverty level. The number of children under the age of 18 living below the poverty level rose to 29.6% in 2010 from 25% in 2005-20091. These factors have resulted in a strong need for food assistance services. For example, according to the Massachusetts Department of Education, 64% of students in the Worcester Public School system receive free school lunch3. -------------------------------------------------- 1. U.S. Census, Quick Facts Population estimates, July 1, 2017, (V2017) 2010 and 2010 American Community Survey 1-year estimates, U.S. Census 2. Massachusetts Executive Office of Labor Workforce and Development 3. Massachusetts Department of Education Demographics: Worcester is the largest site for refugee resettlement in Massachusetts, with more than 1,600 refugees resettled in the city in the past five years. As a result, the City of Worcester's foreign born population is significantly higher than Worcester County as a whole, accounting for the majority of this population in the region. According to U.S. Census 2010 figures, the Hispanic population and other non-Hispanic, non-White ethnic groups in the city have notably increased while the white, non-Hispanic population has decreased. Reflecting this diversity, ninety percent of all medical interpretations provided by UMMHC are conducted in: Spanish, Portuguese, Vietnamese, Arabic, Albanian and American Sign Language. The remaining ten percent are conducted in other "non-primary" languages, the pool of which consists of 81 different languages. The senior population in the region also continues to grow as baby boomers reach the age of 65. According to the U.S. Census, residents between the ages of 20-64 account for the majority of the population in Worcester County at 61%. HealthAlliance: Our target populations focus on medically-underserved and vulnerable groups of all ages in North Central Massachusetts. Our most vulnerable populations include children, ethnic and linguistic minorities and those living in poverty. These populations often become isolated and disenfranchised due to negligence, misperceptions and even fear. The Study Area configuration for the current assessment includes the 30 surrounding municipalities including nine (9) cities and towns. Within the Health Status and Outcomes section of the report, some data sets reflect a further distillation of data from the communities of: Princeton/ East Princeton; Lancaster/South Lancaster; Groton/West Groton; Townsend/West Townsend; and Winchendon/Winchendon Springs, resulting in a presentation of data from 35 communities. The hospital is actively involved in coalition building that focuses on improving the health of the community, including the Joint Coalition on Health. The Coalition has brought positive change to the service area. HealthAlliance Hospital is also actively engaged with the CHNA 9, whose goal is continuous improvement of health status, with a focus on health equality and addressing and eliminating health disparities. Marlborough Hospital: The City of Marlborough, with a population of 39,818 (July 2015) grew 3.4% from 2010. Marlborough's population is predominately white (80%) followed by Hispanic or Latino (10%), other race is 7%, Asian 5%, black or African American 2% and 3% identify themselves as 2 or more races. Hudson has a population of 14,907 with 90% who identify themselves as white, 4% Hispanic or Latino, 2% other, 2% Asian, 1% black or African American and 2% indicate two or more races. Quantitative data from U.S Department of Commerce, Bureau of the Census, American Community Survey 5 year estimates, 2010-2014 illustrates that just over threefourths of the Massachusetts population is white (76.9%) which was largely consistent with Marlborough (80%). Both at the state level and in Marlborough, the Hispanic population was the next largest racial/ethnic group. Hudson's population followed a similar pattern, the proportion of its population that identified as white was even larger (90%) followed by Hispanic and Latino. English, Portuguese and Spanish are the predominant language for the communities the hospital serves. Clinton Hospital: Clinton Hospital primarily serves the communities of Clinton, Berlin, Bolton, Lancaster and Sterling with populations of 13,606, 2,866, 4,897, 7,582 and 9,564 respectively. The population of the total service area is 36,759. According to US Census 2010, Clinton has a population of 13,606. Most Clinton residents are White Non-Hispanic (84%), followed by Hispanic (11.6%) and Black Non- Hispanic (1.80%). The Clinton Hospital Service Area is also primarily White Non-Hispanic (88%), followed by Hispanic (6.4%), and Black Non-Hispanic (2.8%). Clinton Hospital's Community Benefits Plan focuses on the needs of Clinton due to its large concentration of diverse, vulnerable populations.
Schedule H, Part VI, Line 5 Promotion of community health Every year, UMass Memorial Health Care develops, participates in and financially supports a wide variety of community-based programs and services aligned with the hospital's community health improvement priority areas. In FY17, these included: Access to Care, Access to Healthy Food/Healthy Weight, Mental Health, Pediatric Asthma and Behavioral Health. Our clinical system utilizes surplus funds to support community health efforts. UMass Memorial Health Care contributes to the community in ways that are not quantified as part of this report and serves as an important community resource. The majority of the organization's governing body is comprised of persons who reside in Central Massachusetts who are neither employees nor independent contractors of the organization, nor family members thereof. Furthermore, the organization extends medical staff privileges to all qualified physicians in its community for some or all of its departments or specialties. UMass Memorial Health Care also serves as an important community resource by extending staff privileges to all qualified physicians in the community. The system medical staff totals 1,703 members including residents, fellows and hospitalists. UMass Memorial Health Care discharged 49,816 inpatients and provided 1,530,529 outpatient encounters in 2017.
Schedule H, Part VI, Line 6 Affiliated health care system Our clinical system is comprised of four hospitals which each site having a dedicated Community Benefits staff that works with their respective communities in conducting a CHNA, a CHIP and an Implementation Strategy. HealthAlliance: During fiscal year 2017, UMass Memorial - HealthAlliance Hospital worked with our community partners via the CHNA9 to create a North Central Community Health Improvement Plan (CHIP). The North Central CHIP is based on the 2012 and 2015 Community Health Assessments conducted for our region. In the spring and summer of 2015, members of the Community Health Network for North Central Mass (CHNA 9) steering committee analyzed the results of the recent Community Health Assessments and identified four consistent areas of need which became the four Priority Areas. To view the CHIP, click visit: http://www.chna9.com/uploads/3/4/2/5/34257345/11864_chna9_proof_r2.pdf Marlborough Hospital: Our clinical system is comprised of four hospitals which each site having a dedicated Community Benefits staff that works with their respective communities in conducting a CHNA, a CHIP and an Implementation Strategy. Clinton Hospital: Our clinical system is comprised of four hospitals which each site having a dedicated Community Benefits staff that works with their respective communities in conducting a Community Health Needs Assessment, a Community Health Improvement Plan and its hospital's Implementation Strategy.
Schedule H, Part VI, Line 7 State filing of community benefit report MA
Schedule H (Form 990) 2016
Additional Data


Software ID: 16000421
Software Version: 2016v3.0