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 Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
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) . . . 		    25,684,934 14,036,113 11,648,821 0.41 %
b Medicaid (from Worksheet 3, column a) . . . . .     395,709,905 331,371,676 64,338,229 2.27 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     38,875,347 38,646,569 228,778 0.01 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 460,270,186 384,054,358 76,215,828 2.69 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     10,276,154 5,339,760 4,936,394 0.17 %
f Health professions education (from Worksheet 5) . . .     238,962,199 126,983,848 111,978,351 3.95 %
g Subsidized health services (from Worksheet 6) . . . .     66,010,389 48,572,907 17,437,482 0.62 %
h Research (from Worksheet 7) .     0 0 0 0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     2,292,871 2,117,049 175,822 0.01 %
j Total. Other Benefits . . 0 0 317,541,613 183,013,564 134,528,049 4.75 %
k Total. Add lines 7d and 7j . 0 0 777,811,799 567,067,922 210,743,877 7.43 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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     0 0 0 0 %
2 Economic development     0 0 0 0 %
3 Community support     17,897 0 17,897 0 %
4 Environmental improvements     0 0 0 0 %
5 Leadership development and
training for community members		     0 0 0 0 %
6 Coalition building     19,023 0 19,023 0 %
7 Community health improvement advocacy     7,801 0 7,801 0 %
8 Workforce development     11,729 0 11,729 0 %
9 Other     0 0 0 0 %
10 Total 0 0 56,450 0 56,450 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 Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
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
46,393,000
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
2,787,719
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
457,537,497
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
495,673,146
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-38,135,649
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) 2019
Schedule H (Form 990) 2019
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?3Name, 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
https://www.umassmemorialhealthcare.org/umass-memorial-medical-center
V111 		X X X X   X X      
2 UMASS MEMORIAL HEALTHALLIANCE-CLINTON HOSPITAL INC
60 HOSPITAL ROAD
LEOMINSTER,MA01453
www.umassmemorialhealthcare.org/healthalliance-clinton-hospital
VWPE 		X X   X     X      
3 MARLBOROUGH HOSPITAL
157 UNION STREET
MARLBOROUGH,MA01752
www.umassmemorialhealthcare.org/marlborough-hospital
2103 		X X   X     X      
Schedule H (Form 990) 2019
Page 4
Schedule H (Form 990) 2019
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 17
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 18
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/about-us/community-benefits-program/umass-memorial-medical-c
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) 2019
Page 5
Schedule H (Form 990) 2019
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
See Part VI
b
See Part VI
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Page 6
Schedule H (Form 990) 2019
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) 2019
Page 7
Schedule H (Form 990) 2019
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) 2019
Page 4
Schedule H (Form 990) 2019
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 HEALTHALLIANCE-CLINTON 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 17
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 17
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) 2019
Page 5
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
UMASS MEMORIAL HEALTHALLIANCE-CLINTON 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
See Part VI
b
See Part VI
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Page 6
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
UMASS MEMORIAL HEALTHALLIANCE-CLINTON 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) 2019
Page 7
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
UMASS MEMORIAL HEALTHALLIANCE-CLINTON 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) 2019
Page 4
Schedule H (Form 990) 2019
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 19
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 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.ummhealth.org/sites/umass-memorial-hospital/files/2019-2021%20Community%20Be
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) 2019
Page 5
Schedule H (Form 990) 2019
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
See Part Vi
b
See Part Vi
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Page 6
Schedule H (Form 990) 2019
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) 2019
Page 7
Schedule H (Form 990) 2019
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) 2019
Page 8
Schedule H (Form 990) 2019
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, 20a, 20b, 20c, 20d, 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 3E Yes, the significant health needs identified in the CHNA are a prioritized description of the significant health needs of the community. The community engagement process for the CHNA culminated with a community meeting of service providers, stakeholders and residents held at the Worcester Public Library, where CHNA key findings were presented and a prioritization process took place. This event was attended by approximately 75 people.
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 The Coalition for a Healthy Greater Worcester which served in an advisory role in the development of its 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 and prioritization on community health-related strengths, needs, and a vision for the future. The CHNA process gathered extensive quantitative data from federal, state and local sources for the City of Worcester, and the outlying communities of Shrewsbury, Grafton, Millbury, West Boylston, Leicester, and Holden, including a community health survey of nearly 3,000 individuals who live, work and play in Greater Worcester. Qualitative information was captured through 45 key stakeholder interviews, ten focus groups, four community forums, a strategic retreat, a community health survey conducted at multiple community events and an online survey. These sessions gathered critical community input from service providers, community leaders and neighborhood residents with an emphasis on engaging at-risk populations (e.g., Focus groups included: Hispanics/Latinos, youth, South East Asians and individuals with disabilities) as well as service providers representing fields including; behavioral health providers, health providers for elders and public health officials. 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: Academic Health Collaborative, Worcester Division of Public Health Central MA Tobacco Free Partnership City of Worcester Clark University Coalition for a Healthy Greater Worcester Edward M. Kennedy Health Center Family Health Center of Worcester HOPE Coalition Latino Educational Institute Massachusetts Department of Public Health Muslim Community Link Regional Environmental Council of Worcester Reliant Medical Group UMass Medical School Women In Action Worcester Food Policy Council YouthConnect/Boys & Girls Club of Worcester YWCA Central Massachusetts Worcester Public Schools Worcester Regional Research Bureau
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 150 community stakeholders and hosted by the Worcester City Manager, Worcester Director of Public Health (WDPH), Senior Vice President of UMass Memorial Health Care, the UMass Memorial Vice President of Community Relations and the Director of Community Relations, Fallon Health. The CHNA was additionally publicized through various venues including; in local news and communications of CHNA-8, a Healthy Communities Coalition.
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 2018 and developed its Community Benefits Strategic Implementation Strategy. The prioritization process of identified community health needs was led by the Worcester Division of Public Health, Fallon Health and the hospital Vice President of Community Benefits and included input from 75 community stakeholders. The hospital's Community Benefit Strategic Implementation Strategy aligns with the priority findings of the Community Health Needs Assessment (CHNA) and the Greater Worcester Community Health Improvement Plan (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. Community Benefits target populations are identified through a community input and planning process including a range of focus groups, key stakeholder interviews, forums and surveys. This includes the CHNA process and the development of a Community Health Improvement Plan (CHIP) to address the Priority Areas identified in the CHNA. Priority Areas identified in the 2018 CHNA are: Mental Health, Substance Use, Chronic and Complex Conditions and Social Determinants of Health. An additional identified Priority Area is Health Equity, that is cross-cutting across each of these. UMMMC addressed these Priority Areas through the following programs and efforts in 2020: * UMass Memorial has provided ongoing support since 2008 for the Coalition for a Healthy Greater Worcester, a healthy communities coalition, that plays a leadership role in organizing CHIP Working Groups for each of the CHNA Priority Areas and in securing significant funding for community health improvement efforts such as securing a $3.5 Million Centers for Disease Control REACH grant focused on Latino health. Mental health: * Youth Mental Health Model: The Model employs a unique approach to adolescent mental health by integrating prevention and crisis intervention counselors into the milieu at community-based, youth-serving programs where nearly 100% of the youth are low-income and roughly 90% are Latino or African American. In 2020, the program served approximately 675 at-risk youth in one-on-one counseling sessions, therapeutic groups and crisis interventions through its therapeutic partner. * Worcester Addresses Childhood Trauma (Worcester ACTs): A unique, community-wide Community Health Worker (CHW) Resilient Home Visiting Program for children that have experienced or witnessed adverse childhood experiences (ACEs). As a means of reducing future violence, this intervention introduces a clinical response at the point of a trauma, as soon as possible after an incident involving police. The effort is a partnership among the Worcester Police Department (WPD), YWCA, Community Healthlink (a UMMMC mental health provider), UMass Medical School Child Trauma Center, UMMHC Child Protection Program, WDPH, and Clark University. Substance use: * Healthy Options for Prevention and Education (H.O.P.E.) Coalition Peer Leaders: A youth/adult partnership started in 2002 that addresses public health concerns affecting at-risk youth, including tobacco and alcohol use, violence and access to mental health. H.O.P.E. Peer Leaders co-chair the Youth Substance Abuse Prevention Task Force with the WDPH. * UMMMC provides medical services at the Hector Reyes House: A residential substance abuse treatment program for Latino men providing on-site medical care, cognitive behavioral therapy and job training to reduce relapse. Serves 80 men annually including returning clients receiving ongoing care. Social Determinants of Health: Access to Care: * UMMMC operates the Ronald McDonald Care Mobile Program: A mobile clinic established in 2000 providing medical and preventive dental services in 10 low income neighborhoods and 20 inner-city elementary schools in Worcester. Patients are served regardless of insurance status and assisted in enrollment into a medical and dental home and connection to social support services. The program plays a critical role in addressing the high level of tooth decay due to a lack of fluoride in the City's water supply. Due to the onset of the COVID-19 pandemic, beginning in April 2020, the Care Mobile pivoted to conducting COVID-19 education and outreach on safety protocols, proper masking and hand hygiene in neighborhoods of color most affected by the virus. * Oral Health Task Force: Is coordinated and supported by the UMMMC Care Mobile program to ensure that among task force providers, preventive dental services are delivered to at-risk children in public and charter schools. Collaborators include Worcester Public Schools, two community health centers, a community college, MDPH and a college of pharmacy. * CommunityHELP: An online technology platform to improve accessibility of community resource information and social determinants of health. A collaborative effort with Reliant Medical Group, the platform can be viewed in multiple languages and links patients with needed community resources. * Medical-Legal Partnership: A partnership with UMMMC's Legal Department and Community Legal Aid, Inc. that assists Medicaid-eligible, socially complex patients in addressing a wide array of social determinants of health needs. The program leverages pro-bono, private legal services with law firms to address multiple social factors. During the COVID pandemic, the MLP implemented remote services. The MLP staff attorney offered virtual clinic hours to each of the four clinics. In 2020, 180 referrals to legal services were made to pro-bono attorneys. * Support of Community Health Centers: To increase the capacity of two federally qualified community health centers' ability to provide primary care for vulnerable populations and address a shortage of providers, UMMMC grants a rental subsidy annually to the Family Health Center of Worcester (FHC). UMMMC's contribution in this effort equates to a minimum of $2.6 Million annually. * Health Insurance Enrollment Assistance: Is provided by our Financial Counselors to improve access to health care. About 8,500 people receive health insurance enrollment assistance each year. Chronic/complex conditions and their risk factors: * UMMMC established and co-chairs a city-wide Pediatric Asthma Home Visiting Intervention to reduce school absenteeism, hospitalizations and ED use among high risk asthmatic children in Worcester where rates of pediatric asthma-related ED visits are double that of the state. The partnership includes all Worcester Public Schools (WPS)/Head Start Programs, two community health centers and the City's Healthy Homes Office. This community/clinical linkage model utilizes trained, Community Health Workers (CHW) to address asthma triggers in the home. CHWs provide education to address medication adherence. Referrals are made to community resources and Community Legal Aid (CLA) to resolve home triggers that require landlord remediation actions. Due to the COVID-19 pandemic, beginning in March of 2020, the program discontinued in-person home visits and adapted by conducting home visits via Zoom and Facetime. * Working with WPS, UMMMC Pediatric Pulmonology Department operates AsthmaLink, a medication adherence program enrolling 85-100 students yearly that provides consultation, coordination of controller medications given by school nurses and connection to the home visiting intervention. The Pulmonology Division also provides training to school nurses, clinical providers and launched an innovative "Hospitalized Patient Intervention" which links pediatric patients admitted to the hospital to the CHW Pediatric Asthma Intervention. This intervention establishes communication with medical residents within the ED. In 2020, due to the closing of schools as a result of the COVID-19 pandemic beginning in March. CHWs assisted the Pedi-Pulmonology Department in the launch of a text-message communication system regarding medication adherence for high-risk patients. Access to Healthy Food/Hunger/Food Insecurity: UMass Memorial provides funding to key community stakeholders addressing food insecurity and access to healthy foods. These include: * The Worcester Regional Environmental Council's urban agricultural program that provides youth jobs, leadership development and produce for a Veggie Mobile that addresses food insecurity across the City. *UMMMC Community Benefits staff also serve as a member of the Worcester Food Policy Council (WFPC) Steering Committee that convenes the CHIP Access to Healthy Foods Work Group to promote healthy weight/healthy eating and improve nutrition in distressed, food insecure neighborhoods through policy. To improve access to healthy food for underserved, food desert areas the Council works on a range of issues including healthy food retail, SNAP/Healthy Incentives Program, (continued)
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 3E Yes, the significant health needs identified in the CHNA are a prioritized description of the significant health needs of the community. The community engagement activities for the CHNA culminated throughout five community, provider focus groups, and three community forums in the UMass Memorial HealthAlliance-Clinton Hospital's service area where information was gathered, and input was received from service providers, community leaders, and residents. The engagement process was held at the areas listed below where CHNA key findings were presented and a prioritization process took place. Approximately 100 people attended the focus groups and community forums.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance-Clinton Hospital. UMass Memorial HealthAlliance-Clinton Hospital conducted comprehensive Community Health Needs Assessment (CHNA) that gathered, analyzed and documented qualitative and quantitative data. The hospital's 2018 CHNA was developed through a collaborative process involving both administrative and clinical staff at the hospital working with a diverse CHNA Advisory Group made up of health and social service providers, local public health officials, community health advocates, and other community leaders. The Advisory Committee's input and involvement was central to the CHNA and strategic plan development process informed and based on the Hospital's Community Health Improvement Plan (CHIP). Since the beginning of the assessment, more than one hundred individuals participated in key stakeholder interviews, focus groups, and community forums. Key stakeholder interviews were conducted with eighteen community leaders and staff members at UMass Memorial HealthAlliance-Clinton Hospital. Key stakeholder interviews were done to collect qualitative information from key health and social service providers, city/town officials, representatives from community organizations or advocacy groups, and other community leaders to (1) confirm and refine findings from secondary data, (2) provide community context, (3) clarify needs and priorities of the community. Five community and provider focus groups with key segments of the population and/or key types of service providers were also conducted in HealthAlliance-Clinton Hospital's service area. This activity allows for the collection of more targeted and nuanced information from segments of the population who are deemed most at-risk and the key service providers who serve these populations and are critical to community health improvement. Focus groups (1) augment findings from secondary data and key informant interviews and (2) allow for exploration of strategic and programmatic options to address identified health issues, service gaps, and/or barriers to care. Three Community Forums for the public at-large were also conducted in the towns of Fitchburg, Leominster, and Clinton. Community forums allow to capture information directly from community residents and, to some extent, representatives from local service providers or community organizations. Input is captured from residents on (1) community health needs and priorities, (2) service system gaps, (3) barriers to care across a wide array of health-related service and community resource domains (e.g., health, housing, transportation, safety, food access). Forums are critical to fulfilling a comprehensive community engagement plan and will support the development of a sound and objective health needs assessment that will be used to develop programs that reduce disparities and improve health status.
Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance-Clinton Hospital. The Community Health Needs Assessment was conducted with input from our community partners including: Community Health Network Association 9 (CHNA9), Community Health Connections, The Joint Coalition on Health and the Montachusett Public Health Network.
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - UMass Memorial - HealthAlliance-Clinton Hospital. The hospital conducted its most recent Community Health Needs Assessment (CHNA) in fiscal year 2018 and developed its Community Benefits Strategic Implementation Strategy. The CHNA included a prioritization process that identified the most pressing needs that offer opportunities to partner and leverage resources. The prioritization process was led by the Steering Committee with the support of the Hospital's staff, CHNA Advisory Committee, Patient Family Advisory Council (PFAC), other stakeholders and included input from 18 community stakeholders. The hospital focused its programs and initiatives in the following Priority Areas: 1) Health Equity, 2) Behavioral Health (mental health and substance use), 3) Chronic/Complex Conditions and Risk Factors, 4) Healthy Relationships and Domestic/Interpersonal Violence, and 5) Healthy Aging identified as a result of the hospital's latest community health assessment (2018). The hospital continues to aim their efforts on the medically-underserved and vulnerable groups of all ages, specifically targeting our outreach to low-income populations, racial/ethnic minority and indigenous populations, recent immigrants, non-English speakers, and older adults as priority populations that deserve special attention. The hospital's Community Benefit Strategic Implementation Strategy aligns with the priority findings of the Community Health Needs Assessment (CHNA) and the Community Health Network Area 9 (CHNA9) of North Central Massachusetts Community Health Improvement Plan (CHIP). UMass Memorial HealthAlliance-Clinton Hospital developed, implemented, and distributing funds in community benefits through the Determination of Needs (DoN) funding from the hospital's emergency department capital project. These funds represented a portion of the DoN funds distributed to the community through fiscal year 2020. Distribution was limited to programs that specifically address components of the hospital's 2018 community health needs assessment. The following are Community Activities / Strategies that address the identified health priorities needs were implemented during FY 2020: 1) Health Equity: * Anchor Mission: UMass Memorial HealthAlliance-Clinton Hospital works in collaboration with the system's Anchor Mission focusing on four pillars: Local Procurement, Workforce Development, Investment and Volunteerism as a means of improving the economic status, health and well-being of vulnerable, low-income populations in targeted areas. For example, a diverse Hiring Committee works with community-based, workforce organizations serving vulnerable populations. The Hospital's Community Health Director and Sr. Director of External Affairs serves on several UMass Memorial Anchor Mission Task Forces that are working with different community groups on workforce development neighborhood revitalization/housing, poverty and employee engagement. * Community Health Network Area of North Central Massachusetts (CHNA 9): As part of this statewide effort, the hospital partners with CHNA9 to develop implement and integrate community projects to effectively utilize community resources to create healthier communities through a health equity framework. The hospital's Community Health Director and Community Outreach Coordinator work in collaboration with CHNA 9 as an active steering committee member, help facilitate the north regional Community Health Improvement Plan (CHIP) process, convene community stakeholders to implement the CHIP, and review grant proposals submitted by not-for-profit community-based organizations that address the priority areas. * UMass Memorial HealthAlliance-Clinton Hospital Minority Advisory Council MAC is an active committee of only diverse community members, stakeholders, and hospital personnel who meet monthly to develop ideas and implement strategies on how to combat Institutional Racism, identify issues that affect disadvantaged, underserved populations in our communities, offering solutions to improve social determinants of health and health care experience at HealthAlliance-Clinton Hospital. Representative of the MAC, help to assist in developing recommendations to hospital's senior leadership to: o Increase awareness of health and racial inequities and impacts of social determinants o Reduce barriers to health care services and disparities in health outcomes o Promote cultural sensitivity at the Hospital, the community, and among other clinical and non-clinical partners. 2) Behavioral Health (mental health and substance use): * Opioid Task Force: HealthAlliance-Clinton Hospital formed an Opioid Task Force in response to the growing problem of opioids/substance use in the North Central MA region (Leominster, Fitchburg, Clinton, and surrounding towns). The Task Force aims to bring together healthcare providers, community leaders, patient advocates and community stakeholders to tackle the problem of substance and prescription drug abuse in the area by reducing opioid and addiction, preventing overdose deaths, and improving the well-being of our community. * DoN funds supported Aids Project Worcester Outreach program: HealthAlliance-Clinton Hospital funded supplies to support outreach efforts for the homeless, mental health, and substance use population receiving aid by APW's harm reduction specialist. * DoN funds supported Restoration Recovery Center Inc. providing 76 individuals with recovery assistance and transportation to access health care and other human services. * CHNA 9 Mental Health & Behavioral Health and Substance Abuse Workgroup: The goal of this group is to improve overall mental and behavioral health and wellbeing, including preventing substance abuse, in a culturally responsive and holistic manner in the North Central region. The hospital supports these efforts by the Community Outreach Specialist co-chairing the work group. * Free Community Narcan Training a: 100 Participants learned about Opiate/Opioid overdose Education, how to effectively, and rapidly assess a person that may be overdosing, the appropriate steps to take during an overdose, such as administering Narcan, and rescue breathing and harm reduction. * Organize support groups with mental health organizations in the community to support those living with behavioral health issues and providing support for their families and caregivers. 3) Chronic/Complex Conditions and Risk Factors * WHEAT Community Cafe: Hospital supports over 500 community members access a warm nutritional meal through a feeding program at the WHEAT Community Cafe for populations living in poverty. * Hospital Financial Councilor program: Hospital Financial Councilors enroll and educate community members about existing health insurance plans, enrolling over 1,000 community members annually. * DoN funds supported several community base organizations(MOC, Growing Places, and WHEAT food insecurity programs) addressing "social determinants of community health" affected by COVID-19 pandemic providing emergency food and supplies to families who are homebound or facing economic hardships due to COVID19 pandemic. * DoN funds supported Fitchburg Public library to deliver Managing Diabetes evidence base program 4) Healthy Relationships and Domestic/Interpersonal Violence * The hospital partners with YWCA (Daybreak) displaying "Empty Place" display at each hospital campus: a virtual art exhibition which features dinner place settings representing real victims of domestic violence missing from their family's lives, educational materials and a public comment/feedback box. 5) Healthy Aging * DoN funds supported a lending assistive technology program for the hard of hearing population to allow individuals with hearing impairment enjoy community events, classes, and music. * DoN funds supported "Going steady" a nine- week Fall prevention and balance evidence base program for seniors. Other health needs that are not included in the CHNA/CHIP are not being addressed due to limited funding or resources.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - UMass Memorial HealthAlliance-Clinton Hospital, Inc.. UMass Memorial HealthAlliance-Clinton Hospital, Inc. The 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 3E Yes, the significant health needs identified in the CHNA are a prioritized description of the significant health needs of the community.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Marlborough Hospital. To understand public perceptions around a range of health issues in the MetroWest region, a community health survey was developed and administered online and via paper surveys to residents throughout the 22 communities. The survey explored key health concerns of community residents, access to services, and their primary priorities for services and programming. The MetroWest community partners disseminated the survey link via their networks as well as through local media. The survey was available in English, Spanish, and Portuguese and was advertised through language-specific channels as well. A total of 799 respondents were included in the final sample. The majority (78.4%) of survey respondents were female and over half (55.5%) were age 50 years or older. One quarter (25.2%) of respondents self-identified as a minority race/ethnicity, including 13.1% who identified as Hispanic or Latino.
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 and CHNA7
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Marlborough Hospital. UMass Memorial - Marlborough Hospital, FY2020 Community Benefits target populations are identified through a community input and planning process including a range of focus groups, key stakeholder interviews, forums and surveys. This includes the Community Health Needs Assessment (CHA) process and the development of a Community Health Improvement Plan (CHIP) to address the Priority Areas identified in the CHA. Priority Areas identified in the 2019 CHA are: Mental Health, Substance Abuse, Healthy Aging, Access to Health Care and Health and Wellness. Due to the Covid-19 pandemic, most of the Community Benefits outreach programs were canceled or significantly reduced. Marlborough Hospital addressed these Priority Areas through the following programs and efforts in 2020: Build Awareness of Mental Health Issues * Provided conference use for numerous community partners for training programs and educational programs. Community partners included National Association for Mental Illness (NAMI) and Human Services Coalition Access to Care * Assisted residents of the community in enrolling in Mass Health or other health insurance programs. Assistance is offered in English, Spanish and Portuguese. * Improved access to care by providing medical services to elders. Enrolled 429 people into the appropriate health plans. Promote Health and Wellness * Boys & Girls Club - Basketball team sponsorship-$250 * Supported Baseball and Softball program - $250 Covid-19 support to the community Throughout the pandemic, Marlborough Hospital has provided information to residents, non-profit organizations, human services agencies, municipalities, business leaders, elected officials, the press and residents of the communities the hospitals serve regarding Covid, testing, vaccine and other pertinent health information. Hospital leadership held daily briefings during the first surge and community stakeholders were invited to participate. Regular system and hospital Town Hall meeting were held to keep staff and community leaders informed. Anchor mission UMass Memorial's Anchor Mission focuses on four pillars: Local Procurement, Workforce Development and Investment as a means of improving the economic status, health and well-being of vulnerable, low-income populations in targeted areas. For example, a diverse Hiring Committee works with community-based, workforce organizations serving vulnerable populations. We have several Anchor Mission Task Forces that are working with different community groups on workforce development neighborhood revitalization/housing, poverty and employee engagement.
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 (Form 990) 2019
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Schedule H (Form 990) 2019
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) 2019
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Schedule H (Form 990) 2019
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 VI, Line 7 SCH H, PART VI, LINE 7 ALL THREE HOSPITALS 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 V, Section A Schedule H, Part V Section A Clinton Hospital 201 Highland Street, Clinton MA 01510 is the second campus of the UMass Memorial HealthAlliance-Clinton Hospital, Inc. The merger of Clinton Hospital Association with HealthAlliance Hospital became effective 10/1/2017.
Schedule H, Part I, Line 7 Bad Debt Expense Bad Debt Expense has been excluded from Financial Assistance.
Schedule H, Part V, Section B, Line 11 cont. 2: UMass Memorial Medical Center * UMMMC Community Relations staff is also part of the Food is Medicine Massachusetts State Steering Committee, an effort being led by the Harvard University Center for Health Law and Policy Innovation and Community Servings that developed a strategic plan to find ways to increase access to medically-tailored foods and improve the availability of prepared nutritious food for economically-disadvantaged patients being discharged from a hospital. Findings and the full State Plan were published and shared with key stakeholders in 2019. * UMMMC's Maternal-Fetal Medicine and Community Relations departments partnered with the Worcester Division of Public Health to pilot a new, Community Health Worker (CHW) intervention in Maternal-Fetal Medicine to address at-risk pregnancies among Latino women and vulnerable populations; specifically focused on healthy eating and nutrition among at-risk pregnant and lactating women. * Anchor Mission: UMass Memorial's Anchor Mission focuses on four pillars: Local Procurement, Workforce Development and Investment as a means of improving the economic status, health and well-being of vulnerable, low-income populations in targeted areas. For example, a diverse Hiring Committee works with community-based, workforce organizations serving vulnerable populations. We have several Anchor Mission Task Forces that are working with different community groups on workforce development neighborhood revitalization/housing, poverty and employee engagement.
Schedule H, Part V, Section B, Line 16a Line 16c - FAP Website - UMASS MEMORIAL MEDICAL CENTER, INC The FAP, the FAP application form, and a plain language summary of the FAP were widely available on the following website for UMASS MEMORIAL MEDICAL CENTER, INC: https://www.umassmemorialhealthcare.org/umass-memorial-medical-center/patients-visitors/patient-resources/financial-assistance-and-credit-and-collection-policy
Schedule H, Part V, Section B, Line 16a Line 16c - UMASS MEMORIAL HEALTHALLIANCE-CLINTON HOSPITAL The FAP, the FAP application form, and a plain language summary of the FAP were widely available on the following website for UMASS MEMORIAL HEALTHALLIANCE-CLINTON HOSPITAL, INC: HTTPS://WWW.UMASSMEMORIALHEALTHCARE.ORG/HEALTHALLIANCE-CLINTON-HOSPITAL/PATIENTSVISITORS/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE-AND-CREDIT-AND-COLLECTION-POLICY
Schedule H, Part V, Section B, Line 16a Line 16c - FAP Website - MARLBOROUGH HOSPITAL The FAP, the FAP application form, and a plain language summary of the FAP were widely available on the following website for MARLBOROUGH HOSPITAL: HTTPS://WWW.UMASSMEMORIALHEALTHCARE.ORG/MARLBOROUGH-HOSPITAL/PATIENTSVISITORS/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE-AND-CREDIT-AND-COLLECTION-POLICY
Schedule H, Part V, Section B, Line 11 cont. 1: UMass Memorial Medical Center minimum wage, and expanding urban agriculture opportunities. * UMMMC Community Benefits staff is also part of the Food is Medicine Massachusetts State Planning effort being led by the Harvard University Center for Health Law and Policy Innovation and Community Servings that developed a strategic plan to find ways to increase access to medically-tailored foods and improve the availability of prepared nutritious food for economically-disadvantaged patients being discharged from a hospital. In 2020, Community Benefits staff continued to serve on the FIMMA Steering, Provider Education, Older Adult and other FIMMA Committees. * UMMMC's Maternal-Fetal Medicine and Community Relations departments partner with the Worcester Division of Public Health in a Community Health Worker (CHW) intervention in Maternal-Fetal Medicine to address at-risk pregnancies among Latino women and vulnerable populations. The funding for this intervention was provided by the Centers for Disease Control and Prevention (CDC) REACH Grant, to support a CHW to address breastfeeding and linkages to community supports for social determinants of health and nutrition among at-risk pregnant and lactating women. Due to the COVID-19 pandemic, beginning in March of 2020, the program discontinued in-person home visits and adapted by conducting home visits via Zoom and Facetime. * Anchor Mission: UMass Memorial Health Care system-wide Anchor Mission was formally adopted in 2018 and continued with a strong focus in 2020 to leverage the assets of the organization to address social determinants of health. UMass Memorial's Anchor Mission focuses on four pillars: Local Procurement, Workforce Development, Investment and Volunteerism as a means of improving the economic status, health and well-being of vulnerable, low-income populations in targeted areas. For example, a diverse Hiring Committee works with community-based, workforce organizations serving vulnerable populations. These include unemployed adults and youth, English as a Second Language (ESL) learners, teen mothers, those seeking General Education Development (GED) and newly arrived immigrants/refugees to identify barriers to viable employment and growth opportunities to formalize a hiring pipeline. The Anchor Mission Procurement Committee is working on local purchasing processes and identifying local vendor contract opportunities and the Investment Committee has allocated $4.0 Million in hospital investment funds to address community issues such as housing needs for chronically-homeless through a collaborative with bankers, philanthropic organizations and City Government/Housing Authority. Several brick and mortar neighborhood revitalization were granted including the Worcester East Side CDC in its pre-construction planning of a tiny homes project for homeless elders. * COVID-19: In response to the onset of the COVID-19 pandemic, UMass Memorial developed and implemented a multi-pronged, community-based approach to combat COVID-19 within neighborhoods targeting populations most at-risk. Beginning with the COVID-19 "Feet on the Street" outreach, the hospital's Care Mobile staff were swiftly redeployed to provide education and demonstration on handwashing, proper mask use, answers to COVID-19 questions in Spanish and English and written materials provided in six languages. The intervention distributed face masks, sanitizer and information on critical resources including food, housing and evictions, access to flu shots, voter registration and U.S. Census. * In August 2020, UMass Memorial was asked to lead the Massachusetts' 'Stop the Spread' COVID-19 testing in Worcester's in high positivity areas. The hospital developed and implemented a COVID-19 testing operation able to; function effectively out- or indoors as weather changed, rotate events into various hot-spot neighborhoods of color and vulnerability based on data, provide same-day set up and break down and function with minimal or no WiFi or access to power, successfully manage unpredictable volumes while meeting the language needs of Worcester's diverse populations. Strategies included utilizing neighborhood hot-spot/positivity data, PDSAs focused on efficiency, and a robust partnership effort with multiple community organizations including public health. In November 2020, the program moved indoors into a central location with easy access to minimize transportation barriers. Most importantly, our COVID-19 neighborhood-based intervention was led by our Health Equity initiative, which has community stakeholders and our partner the Worcester Division of Health and Human Services analyzing the data and providing input on direction.
Schedule H, Part I, Line 7f Community Benefit Expense as a Percent of Total Expenses The Schedule H instructions provide guidance for group return filers to report the "total expense" denominator for purposes of determining the percent of total expense for column (f) is the amount reported on Form 990, Part IX, line 25, column (A), of the group return. Therefore, Schedule H column F of this group return is presenting the consolidated total from the group statement of functional expenses, instead of including the functional expenses of hospital facilities only arriving at 7.43%. However, the more accurate representation of community benefit expenses for the hospitals would be based on using the functional expenses of the hospital facilities only in the denominator, which would be 9.31%
Schedule H, Part I, Line 7g Subsidized Health Services Not applicable
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost to charge ratio is the costing methodology used to calculate the amounts reported in 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 activities and others.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount On October 1, 2018 , the System adopted ASU 2014-09 Revenue from Contracts with Customers and all subsequent amendments to the ASU (collectively, "ASC 606") which outlines a five-step framework that supersedes the principles for recognizing revenue (previously "ASC 605") and eliminated industry-specific guidance. This framework ensures that entities appropriately reflect the consideration to which they expect to be entitled in exchange for goods and services by allocating transaction price to identified performance obligations and recognizing revenue as performance obligations are satisfied. Qualitative and quantitative disclosures are required to enable users of the financial statements to understand the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers. The System adopted ASC 606 using a modified retrospective approach. The presentation and disclosure of revenue primarily related to uninsured or underinsured patients changed because of the adoption of ASC 606. Under the provisions of ASC 606, the estimated uncollectible amounts due from self-pay patients, as well as co-pays and co-insurance obligations of patients with insurance, generally considered implicit price concessions, are required to be reflected as a direct reduction to patient service revenue as opposed to the previous reporting as a provision for doubtful accounts. As a result, for the year ended September 30, 2020, the System recorded approximately $46,393,000 of implicit price concessions as a direct reduction of patient service revenue that would have previously been recorded as provision for doubtful accounts and $48,365,000 as a direct reduction of accounts receivable.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology Based on historical experience, a significant portion of the System's uninsured patients will likely be unable or unwilling to pay for the services provided and are considered an implicit price concession. Estimates of implicit price concessions are determined based on historical collection experience with these classes of patients using a portfolio approach as a practical expedient to account for patient contracts as collective groups rather than individually. The financial statement effects of using this practical expedient are not materially different from an individual contract approach. Changes in the economy, unemployment rates, the number of uninsured and underinsured patients, the volume of patients through emergency departments, the increased burden of co-pays, co-insurance amounts and deductibles to be made by patients with insurance, and business practices related to collection efforts are some of the factors that can impact collection trends and the estimation process. 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 implicit price concession amounts amounts in community benefits would be to account for those patients who were classified as an implicit price concession, 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 Notes to Consolidated Financial Statements, page 18 of Audited Financial Statements: For patient accounts receivable after adoption of ASU 2014-09 on October 1, 2018, the estimated uncollectible amounts are generally considered implicit price concessions that are a direct reduction to patient accounts receivable rather than allowance for doubtful accounts.
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: See Part VI; - UMASS MEMORIAL HEALTHALLIANCE-CLINTON HOSPITAL, INC.: Line 16a URL: See Part VI; - MARLBOROUGH HOSPITAL: Line 16a URL: See Part Vi;
Schedule H, Part V, Section B, Line 16b FAP Application website - UMASS MEMORIAL MEDICAL CENTER, INC: Line 16b URL: See Part VI; - UMASS MEMORIAL HEALTHALLIANCE-CLINTON HOSPITAL, INC.: Line 16b URL: See Part VI; - MARLBOROUGH HOSPITAL: Line 16b URL: See Part Vi;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - UMASS MEMORIAL MEDICAL CENTER, INC: Line 16c URL: See Part VI; - UMASS MEMORIAL HEALTHALLIANCE-CLINTON HOSPITAL, INC.: Line 16c URL: See Part VI; - MARLBOROUGH HOSPITAL: Line 16c URL: See Part Vi;
Schedule H, Part VI, Line 2 Needs assessment UMass Memorial Medical Center: 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 (CHIP). In 2018, the Vice President of Community Relations and the Community Health Manager continued to serve as members of the Steering Committee of the Coalition for a Healthy Greater Worcester, a healthy communities coalition that coordinates and provides accountability for CHIP Priority Area Working Groups, participates in the CHIP Access to Care group, the CHIP Data Committee and a subcommittee for oversight of UMass Memorial Medical Center Determination of Needs (DoN) funds distribution. 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 Benefits Strategic Implementation Plan 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 * 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 * 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 and organizations who have expertise on community health issues. The health needs identified in the CHNA are a prioritized description of the significant health needs of the community. The community engagement process for the CHNA culminated with a meeting of service providers, stakeholders and residents held at the Worcester Public Library, where CHNA key findings were presented and a prioritization process took place. This event was attended by approximately 75 people UMass Memorial HealthAlliance-Clinton Hospital Inc. : In addition to the CHNA, UMass Memorial HealthAlliance-Clinton Hospital Management Team plays an active role in the Community Benefit Program by sharing information regarding needed programs, services and support. Members of the Community Benefits Team and the Management Team also participate in various community agency boards, coalitions, committees, community events, and health fairs. These groups and events play a significant role in defining needs, generating program ideas and creating services, programs, and support groups. Community Benefits activities and goals are also shared with the Board of Trustees for their feedback. UMass Memorial HealthAlliance-Clinton Hospital works closely with the CHNA9 which is comprised of representatives from a diverse group of agencies, providers, schools, community organizations and community members. The hospital also works with CHNA9 members: A.E.D. Foundation, Inc. Arc of Opportunity Central Mass Agency on Aging, Clinton Adult Learning Center, Community Health Connections, Community Health link, Fitchburg Board of Health, Fitchburg Department of Community Development, Fitchburg Police Department, Fitchburg Public Schools, Fitchburg State University, GAAMHA Inc., Gardner Community Action Team, Gardner Public Schools, Gardner Visiting Nurses Association, Growing Places Inc., Health Care for All Health Disparities Collaborative, Health Foundation of Central Mass, Heywood Healthcare, Joint Coalition on Health, Leominster Public Schools, LUK, Inc., MA Department of Corrections, MA Department of Public Health, Massachusetts Public Health Association, Montachusett Community Branch YMCA, Montachusett Home Care, Montachusett Opportunity Council, Montachusett Veterans Outreach Center Inc., Montachusett Public Health Network, Mount Wachusett Community College, NAMI of North Central Mass, Nashoba Regional School District, Nashoba Valley Medical Center, North Central Mass Coalition for Healthy Relationships, North Central Mass Minority Coalition, North Central WIC, The SHINE Initiative, South Bay Mental Health, Spanish American Center, Suicide Prevention Task Force, Sunrise Senior Living, Three Pyramids Training Resources of America, Transportation for Massachusetts, UMass Medical School Center for Tobacco Treatment, United Neighbors of Fitchburg, United Way of Tri-County/Wheat Community Connections, Winchendon Board of Health, Winchendon Public Schools, Worcester County Food Bank/Feeding America, You Inc., and YWCA of North Central Marlborough: 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. and assesses the health care needs of the community it serves by working closely with community partners. 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.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance UMass Memorial Medical Center: UMass Memorial Medical Center employs 24 Financial Counselors, also referred to as Certified Application Counselors (CAC's). All Financial Counselors are state certified and located on all campus locations. The Patient Financial Counseling department has a dedicated call center line that is available to patients and any member in the community that requires assistance. Patient's are referred to the Financial Counselors from many community organizations, such as the local community actions councils and area Health Centers. Financial Counseling assistance is provided at several area free clinics to assist patients in the application process. The Patient Financial Counseling department assists patient's at bedside on inpatient units and patients in the emergency department setting. 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, apply for Financial Assistance, 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. UMass Memorial HealthAlliance-Clinton Hospital Inc. UMass Memorial HealthAlliance Clinton Hospital Inc. employs 3 Financial Counselors, also referred to as Certified Application Counselors (CAC's). All Financial Counselors are state certified and located on all campus locations. The Patient Financial Counseling department has a dedicated call center line that is available to patients and any member in the community that requires assistance. Patient's are referred to the Financial Counselors from many community organizations, such as the local community actions councils and area Health Centers. Financial Counseling assistance is provided at several area free clinics to assist patients in the application process. The Patient Financial Counseling department assists patient's at bedside on inpatient units and patients in the emergency department setting. 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, apply for Financial Assistance, 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. Marlborough Hospital: Marlborough Hospital employs 3 Financial Counselors, also referred to as Certified Application Counselors (CAC's). All Financial Counselors are state certified and located on all campus locations. The Patient Financial Counseling department has a dedicated call center line that is available to patients and any member in the community that requires assistance. Patient's are referred to the Financial Counselors from many community organizations, such as the local community actions councils and area Health Centers. Financial Counseling assistance is provided at several area free clinics to assist patients in the application process. The Patient Financial Counseling department assists patient's at bedside on inpatient units and patients in the emergency department setting. 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, apply for Financial Assistance, 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 UMass Memorial Medical Center: Geographical Reach: The 2018 Community Health Assessment (CHNA) and 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 (The Coalition for a Healthy Greater Worcester) that implements key strategies of the CHIP so that future initiatives can be developed in a more coordinated approach. Our focus is on vulnerable populations living in this geographical area Regional Description: The City of Worcester is very ethnically-diverse. 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 American Fact Finder population estimates for 2013-2017 indicated that the median household income for the City of Worcester was $45,869 and for Worcester County region was $69,313. According to the Worcester Regional Research Bureau, of the city's total 184,743 residents, 22% are living below the poverty level. The number of children under the age of 18 living below the poverty level rose to 30% in 2010 from 25% in 2005-2009. 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 lunch. Demographics: Worcester is a Federal Resettlement Site, 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%. UMass Memorial HealthAlliance-Clinton Hospital Inc. UMass Memorial HealthAlliance-Clinton Hospital's primary service area includes the quasi-urban municipalities of Clinton, Fitchburg, and Leominster, and the more rural towns of Ashburnham, Ashby, Gardner, Lunenburg, Townsend, Sterling, and Westminster. The Hospital's secondary service area includes an additional twelve towns: Ayer, Bolton, Groton, Harvard, Hubbardston, Lancaster, Pepperell, Princeton, Shirley, Sterling, Templeton and Winchendon. While great efforts are made to improve the health status, provide diagnostic screening, and address access barriers of all residents within these communities, special attention is given to address the needs of diverse and/or low income, vulnerable segments of the population. The challenges that these cohorts face with respect to social determinants of health and access to care are often intense and are at the root of the challenges and poorer health outcomes faced in these communities. More specifically, the hospital's 2018 CHNA identified low-income populations, African Americans and other racial/ethnic minority populations, recent immigrants, non-English speakers, and older adults as priority populations that deserve special attention. According to the US Census Bureau: * In Fitchburg (6%), a significantly greater percentage of residents speak Spanish at home and English "less than very well" compared to the Commonwealth overall (4%) * Compared to the Commonwealth (11%), the percentage of Hispanic/Latino residents is significantly high in Fitchburg (24%), Clinton (14%), and Leominster (15%). * The percentage of residents identifying as "some other race" besides White, Black or African American, Asian, American Indian/Alaska Native, or Native Hawaiian/Pacific Islander is significantly high in Fitchburg (8%) and Leominster (7%) compared to the Commonwealth overall (4%). Employment, income, and poverty is another area where there was significant variation within the service area. According to the US Census Bureau: * Compared to the Commonwealth overall ($68,563), the median household income was significantly lower in Clinton, Fitchburg, Gardner, and Leominster, yet significantly higher in all other municipalities in the service area. * The percentage of residents that live below the federal poverty line is significantly high in Fitchburg (19%) and Gardner (19%) compared to the Commonwealth (12%). * Compared to the Commonwealth (24%), a significantly high percentage of residents live below 200% of the federal poverty line in Gardner (38%) and Leominster (28%). * The percentage of families, individuals under 18, individuals over the age of 65, and female-headed households living in poverty was significantly high in Fitchburg compared to the Commonwealth overall. Marlborough Hospital: The City of Marlborough, with a population of 39,825 (July 2018) 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 14,603 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
Schedule H, Part VI, Line 5 Promotion of community health The majority of the governing bodies of all our boards overseeing our hospital facilities -community hospitals, inc., and the member hospitals are comprised of persons who reside in the organization's primary service area who are neither employees nor independent contractors of the organization nor family members thereof. All hospital facilities extend medical staff privileges to all qualified physicians in its respective community for some (or all) of its departments or specialties and are also eligible to become part of the faculty of the University of Mass Medical School. UMass Memorial Medical Center: UMass Memorial has a designated Community Benefits department housed within Community Relations that is wholly dedicated to promoting the Community Benefit agenda with a special focus on Community Health Improvement. Our Community Benefits staff works very closely with multiple community organizations forging partnerships. The hospital has a strong and longstanding partnership with the Worcester Division of Public Health which has resulted in significant opportunities that have leveraged funding and implementation of preventive community-clinical linkages. In addition, we work closely with the two Federally Qualified Community Health Centers and leverage internal resources within the system to increase program capacity whenever possible. The Community Relations/Community Benefits Department works closely with Pedi-Primary Care, Family and Community Medicine, Pedi-Pulmonology and the Emergency Department. We also provide medical and dental services to the underserved at 11 neighborhood sites and 20 schools through the UMass Memorial Care Mobile (this function on hold beginning in March 2020 due to the COVID-19 pandemic). Most recently, we have adopted an Anchor Mission as a strategy to specifically address social determinants of health. UMass Memorial HealthAlliance-Clinton Hospital Inc: The hospital has a Community Benefit program that is responsible for promoting the Community Benefit Implementation Strategy focusing on Community Health Improvement. Hospital staff, leaders, and medical providers work very closely with multiple community organizations forging partnerships. In addition, we leverage internal resources within the system to increase program capacity whenever possible. We continue to support health education and screenings related to chronic diseases and prevalent health conditions in the community including mental/behavioral health, lung cancer/smoking cessation, chronic occlusive pulmonary disease (COPD), heart health, depression and nutrition/diabetes. We particularly focus on diverse populations and social determinants of health. UMass Memorial HealthAlliance-Clinton Hospital continued working with the Community Health Network of North Central Mass (CHNA9) and other partners in implementing the North Central Mass Community Health Improvement Plan (CHIP). Most CHIP working groups meet monthly and took significant steps toward reviewing baseline information and creating more partnerships that will enable sharing of resources throughout the CHIP implementation and beyond. Marlborough Hospital: Marlborough Hospital participates in area events and provides facilities for support groups. In addition, whenever possible we leverage internal resources to build capacity in our programming and we have staff that supports Community Benefits activities.
Schedule H, Part VI, Line 6 Affiliated health care system UMass Memorial Health Care is the largest not-for-profit health care system in Central Mass and the largest provider of care for the uninsured outside of Boston; and the only Safety Net provider in Central New England. Our health care system is comprised of UMass Memorial Medical Center as well as the Community Hospitals Health Alliance Clinton and Marlboro Hospitals. We have a reporting parent board and a medical group and affiliate with Community Healthlink which is the largest provider of mental health for vulnerable populations. Each hospital in our system, has a dedicated Community Benefits staff and department that works closely with their respective communities in conducting a the Community Health Needs Assessment, a Community Health Improvement Plan and a Community Benefits Implementation Strategy. In addition, we also share best practices and knowledge and adopt when appropriate. We have been one of the few hospital systems in the country that has adopted an "anchor mission" for our organization. This involves leveraging all of the assets of our organization in order to address pervasive inequality and social disadvantage in our community. We do so by strategically focusing our investment practices, hiring practices and purchasing practices in a manner that addresses the social determinants of health in the community. For example, we have pledged to devote 1% of our investment portfolio ($4 Million) and invest it into the community. We have already deployed almost half of that $4 Million by making four specific investments in the areas of housing and the arts in vulnerable areas of our community.
Schedule H (Form 990) 2019
Additional Data


Software ID: 19010655
Software Version: 2019v5.0