4A (Expenses $ 491634765 including grants of $ 0) (Revenue $ 579862095)
OPERATE AN ACUTE CARE GENERAL HOSPITAL AND MEDICAL EDUCATIONAL FACILITY, AND TO DELIVER THE HIGHEST QUALITY PATIENT CENTERED CARE IN A LEARNING ENVIRONMENT. TOTAL PATIENT DAYS FOR THE YEAR ARE 61,340, TOTAL LAB PROCEDURES 1,690,942, TOTAL RADIOLOGY PROCEDURES 177,707, TOTAL REHAB VISITS 53,735. HOURS OF OPERATION 24/HRS 365/DAYS PER YEAR.

4B (Expenses $ 34785832 including grants of $ 0) (Revenue $ 41389349)
OPERATION OF AN EMERGENCY DEPARTMENT AND TRAUMA CARE CENTER AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. TOTAL VISITS FOR THE YEAR 59,588. ED IS IN OPERATION 24 HRS/DAY 365 DAYS/YEAR.

4C (Expenses $ 14301096 including grants of $ 0) (Revenue $ 8300726)
VISITING NURSE PROGRAM ALLOWING FOR THE CARE AND REHABILITATION OF PATIENTS IN THEIR OWN HOME ENVIRONMENT. TOTAL VISITS FOR THE YEAR 51,462 DETAILED AS FOLLOWS SKILLED NURSING 28,081 HOME HEALTH AIDE 2,141, REHAB 20,825, AND SOCIAL SERVICE 415. HOURS OF OPERATION 7 DAYS/WEEK 8AM-9PM WITH A NURSE ON CALL 24 HOURS.

4D (Expenses $ 3325845 including grants of $ 0) (Revenue $ 2651244)
OPERATE A SUBSTANCE ABUSE CENTER PROVIDING THE HIGHEST QUALITY OF PATIENT CARE. TOTAL PATIENT DAYS FOR THE YEAR 6,657. PROGRAM OPERATES 24 HRS/DAY 365 DAYS/YEAR.

BERKSHIRE MEDICAL CENTER
PART V, SECTION B, LINE 5: THE BMC CHNA HAD ITS TRIANNUAL ASSESSMENT IN 2021 WHICH DIRECTED OUR EFFORTS FOR THIS REPORTING PERIOD OUR FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR 2021 RELIES HEAVILY UPON SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH FRAMEWORK AND THE ROBERT WOOD JOHNSON FOUNDATION'S COUNTY HEALTH RANKINGS TO ANALYZE AND PRIORITIZE THE FACTORS THAT CONTRIBUTE TO THE HEALTH OF A POPULATION. OUR ASSESSMENT INCLUDED THE EVALUATION OF PUBLICLY AVAILABLE DATA, FINDINGS FROM LOCAL ORGANIZATION REPORTS, AND FEEDBACK COLLECTED FROM FOCUS GROUPS AND SURVEYS. WE DEVELOPED OUR THREE-YEAR IMPLEMENTATION PLAN BASED ON THE 2021 CHNA. THE FOLLOWING IS A SUMMARY OF THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2021 CNHA, ORGANIZED INTO THREE OVERARCHING CATEGORIES:HEALTH CONDITIONS AND OUTCOMESCOMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTHBARRIERS TO ACCESSING QUALITY CAREHEALTH OUTCOMES AND BEHAVIORSCHRONIC DISEASE WITH A FOCUS ON CANCER, HEART DISEASE, AND DIABETESBERKSHIRE COUNTY HAS THE HIGHEST RATE OF PREMATURE DEATH IN THE COMMONWEALTH OF MASSACHUSETTS, ACCORDING TO THE ROBERT WOOD JOHNSON FOUNDATION'S COMMUNITY HEALTH RANKINGS (2021). RESIDENTS REPORT A HIGHER RATE OF POOR MENTAL HEALTH DAYS THAN THE STATE OVERALL, AND HAVE HIGHER RATES OF SMOKING (19%), OBESITY (27%) AND EXCESSIVE DRINKING (26%), ALL OF WHICH CONTRIBUTE TO HIGHER RATES OF CHRONIC DISEASE WITHIN THE COMMUNITY. MORE THAN 20% OF THE POPULATION IS OVER THE AGE OF 65, MAKING THE COMMUNITY HIGHLY SUSCEPTIBLE TO THE VARIETY OF INCREASED HEALTH ISSUES THAT ACCOMPANY AGING.MENTAL ILLNESS AND MENTAL HEALTH, INCLUDING SUICIDE PREVENTION AND TREATMENTIN ADDITION TO THE HIGH LEVEL OF REPORTED POOR MENTAL HEALTH DAYS IN THE BERKSHIRE COMMUNITY, RATES OF SUICIDE ARE AMONG THE HIGHEST IN THE STATE AT 17.4 PER 100,000. A RECENT SURVEY OF YOUTH REVEALED A SIMILARLY HIGH LEVEL OF SUICIDAL BEHAVIORS WITH BETWEEN 14-17% OF YOUTH STATING THAT THEY HAD PLANNED A SUICIDE ATTEMPT IN THE PAST 12 MONTHS AND 7-11% OF YOUTH HAVING ATTEMPTED SUICIDE IN THE PAST 12 MONTHS.SUBSTANCE USE DISORDERSBERKSHIRE COUNTY'S RATE OF SUBSTANCE USE HAS SKYROCKETED, AS EVIDENCED BY THE NEARLY 200% INCREASE IN OVERDOSE DEATHS IN THE PAST 10 YEARS. BERKSHIRE COUNTY ALSO REPORTS THE SECOND-HIGHEST RATE OF PREGNANT WOMEN WHO USED OPIOIDS DURING PREGNANCY.COVID-19 TESTING AND VACCINATIONBHS CONTINUES TO PROVIDE THE MAJOR INFRASTRUCTURE SUPPORTING THE COMMUNITY'S RESPONSE TO THE COVID-19 PANDEMIC. DURING THE HEALTH SYSTEM'S FISCAL YEAR ENDED 09/30/2021, BHS PERFORMED MORE THAN 160,000 COVID TESTS AND CARED FOR MORE THAN 500 HOSPITALIZED COVID-19 PATIENTS. COMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTHIMPROVING COMMUNITY SAFETYBERKSHIRE COUNTY RANKS 10TH OF 14 COUNTIES IN THE STATE FOR VIOLENT CRIMES, BUT 3RD IN THE STATE FOR HOMICIDE RISK AT 2.36 PER 100,000 PEOPLE.CREATING INITIATIVES TO IMPROVE SOCIAL DETERMINANTS OF HEALTHA VARIETY OF SOCIAL AND ECONOMIC ISSUES CONVERGE ON BERKSHIRE COUNTY TO CREATE SIGNIFICANT CHALLENGES THAT CAN IMPACT THE HEALTH OF ITS RESIDENTS. BERKSHIRE COUNTY FOLLOWS SUFFOLK AND HAMPDEN COUNTY, RANKING 3RD IN THE STATE (TIED WITH BRISTOL COUNTY) FOR PREVALENCE OF FOOD INSECURITY (9.9%). BERKSHIRE COUNTY HOUSING STOCK IS SIGNIFICANTLY OLDER THAN THE REST OF THE STATE, WITH MORE THAN 45% OF ALL HOUSING BEING BUILT BEFORE 1950, AS OPPOSED TO ONLY 37% FOR THE REST OF THE STATE. THE COUNTY'S MEDIAN HOUSEHOLD INCOME IS AT LEAST 25% LOWER THAN THE STATE AVERAGE AND A HIGHER NUMBER OF CHILDREN UNDER 18 LIVE BELOW THE POVERTY LEVEL (13.9%).BARRIERS TO ACCESSING QUALITY CAREINCREASING INSURANCE ENROLLMENTGIVEN THE AGE AND ECONOMIC DEMOGRAPHIC OF THE COUNTY, MORE THAN 45% OF BERKSHIRE RESIDENTS ARE HEAVILY RELIANT ON PUBLIC SOURCES OF FINANCING FOR ACCESS TO HEALTH CARE. NEARLY 3.0% ARE UNINSURED. ENHANCING THE HEALTHCARE WORKFORCETHE REGION'S SIGNIFICANT RELIANCE ON GOVERNMENT-REIMBURSED SERVICES CAN HAVE A DIRECT INFLUENCE ON LOCALLY AVAILABLE PROGRAMS AND SERVICES. BHS CONTINUES TO FACE STAFFING CHALLENGES, LIKE THOSE EXPERIENCED ACROSS THE NATION AND IS EXPLORING CAREER TRAINING PROGRAMS THAT CAN SIMULTANEOUSLY HELP TO REDUCE CLINICIAN SHORTAGES AND HELP TO RAISE MEDIAN INCOME LEVELS THROUGH STRONG EMPLOYMENT OPPORTUNITIES FOR BERKSHIRE RESIDENTS.CONTINUED ON SCHEDULE O

BERKSHIRE MEDICAL CENTER
PART V, SECTION B, LINE 6A: FAIRVIEW HOSPITAL

BERKSHIRE MEDICAL CENTER
PART V, SECTION B, LINE 11: BERKSHIRE MEDICAL CENTER (BMC) REGULARLY ASSESSES THE HEALTH NEEDS OF BERKSHIRE COUNTY RESIDENTS AS PART OF THE STRATEGIC PLANNING PROCESS AND COMMUNITY BENEFITS PROGRAMMING. BMC COMPILED THE BERKSHIRE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT USING THE EVALUATION OF PUBLICLY AVAILABLE DATA, FINDINGS FROM LOCAL ORGANIZATION REPORTS, AND FEEDBACK COLLECTED FROM FOCUS GROUPS AND SURVEYS. THIS DATA, IN CONJUNCTION WITH THE MASSACHUSETTS FOCUS AREAS AND PRIORITIES, WAS USED TO DETERMINE OUR ANNUAL COMMUNITY BENEFIT PRIORITIES. THE INTENT IS TO BROADLY IDENTIFY THE MAJOR TRENDS IN HEALTH STATUS AND OUR COMMUNITY'S HEALTH NEEDS WITH AN UNDERSTANDING OF THE FACTORS THAT ARE LIKELY TO AFFECT THE POPULATION OF BERKSHIRE COUNTY. THE FRAMEWORK OF THIS PLAN SPANS FISCAL YEARS 2021-2024. THE OBJECTIVES OF THE CHNA ARE TO: TO GATHER STATISTICALLY VALID INFORMATION ON THE HEALTH STATUS OF THE RESIDENTS OF BERKSHIRE COUNTY TO DEVELOP ACCURATE COMPARISONS TO STATE AND NATIONAL BENCHMARKS OF HEALTH AND QUALITY OF LIFE MEASURES TO PROVIDE TRENDING INFORMATION FOR THE FUTURE TO IDENTIFY KEY AREAS OF SIGNIFICANT COMMUNITY NEEDS AND VULNERABLE POPULATIONS TO UTILIZE FINDINGS FOR COMMUNITY BENEFIT AND HOSPITAL PLANNING WHILE DEMOGRAPHIC, SOCIOECONOMIC AND HEALTH STATUS INDICATORS PROVIDE AN EFFECTIVE MEANS OF IDENTIFYING POTENTIAL NEEDS AND/OR PROBLEMS, SUCH A BROAD-BASED VIEW CANNOT IDENTIFY ALL OF THE HEALTH AND HUMAN SERVICE PROBLEMS FACING A COMMUNITY. THIS IS RATHER ONE STEP OF MANY IN AN ON-GOING PROCESS OF COLLECTING AND DISSEMINATING HEALTH STATUS INFORMATION SO THAT, WORKING TOGETHER WE ADDRESS MOST OF THE IDENTIFIED HEALTH NEEDS OF OUR COMMUNITY AND HELP TO ENSURE BETTER OUTCOMES FOR ALL THE PEOPLE LIVING IN BERKSHIRE COUNTY. ADDITIONALLY, AN IMPORTANT PART OF THIS PROCESS IS TO IDENTIFY PREEXISTING PROGRAMS AND RESOURCES IN THE COMMUNITY TO AVOID DUPLICATION OF EFFORTS AND SILOED WORK. WE KNOW THAT COLLABORATING WITH OUR PARTNERS WE CAN BUILD A STRONGER MORE RESILIENT COMMUNITY THAT CAN ADDRESS MOST OF OUR COMMUNITY NEEDS. WHEN PARTNER ORGANIZATIONS ARE ALREADY ADDRESSING A PRIORITY HEALTH NEED, BMC MAY NOT PROVIDE DIRECT SERVICE OR FUNDS HOWEVER SUPPORTS THAT PROGRAM BY PROVIDING REFERRALS, CONNECTIONS, DATA, AND/OR OTHER MODALITIES OF SUPPORT. BASED ON THIS APPROACH, MOST OF THE IDENTIFIED HEALTH NEEDS ARE BEING ADDRESSED BY BMC OR PARTNER ORGANIZATIONS. COMMUNITY BENEFIT AND ACCESS COMMITTEE:AS A STANDING COMMITTEE OF THE BOARD OF TRUSTEES - ITSELF MADE UP OF COMMUNITY VOLUNTEERS, THIS COMMITTEE IS RESPONSIBLE FOR UNDERSTANDING THE HEALTH NEEDS AND BARRIERS TO CARE IN OUR SERVICE AREA. THE COMMITTEE OVERSEES THE COMMUNITY BENEFIT PROCESS OF THE ORGANIZATION, INCLUDING HEALTH NEEDS ASSESSMENTS, DETERMINING TARGET POPULATIONS AND PRIORITIES, DEVELOPMENT OF THE COMMUNITY BENEFITS PLAN AND EVALUATING PERFORMANCE AGAINST GOALS AND OBJECTIVES. THE COMMITTEE IS COMPRISED OF PEOPLE FROM THE BOARD OF TRUSTEES AND THE COMMUNITY AT LARGE. THE BMC COMMUNITY BENEFITS AND ACCESS COMMITTEE REVIEWS AND DISCUSSES COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, AND COMMUNITY NEEDS AND OUTCOMES. THE COMMITTEE FORMALLY REVIEWS ANY UPDATES TO COMMUNITY NEEDS AND REAFFIRMS PRIORITIES ANNUALLY AND COMPLETES A COMPREHENSIVE NEEDS ASSESSMENT EVERY THREE YEARS. THROUGHOUT THE YEAR, INTERNAL COMMUNITY BENEFITS AND PROGRAM LEADERS MEET TO COORDINATE THE COMMUNITY BENEFIT PLAN AND PROGRAMS. DUE TO THE COVID-19 PANDEMIC THIS COMMITTEE DID NOT MEET AS MANY OF THE PARTICIPANTS HAD COMPETING PRIORITIES. OUR COMMUNITY BENEFIT AND ACCESS COMMITTEE ALSO INCURRED CHANGES IN ITS LEADERSHIP STRUCTURE.BMC IS THE ONLY HEALTH SYSTEM IN BERKSHIRE COUNTY AND THEREFORE WE ASSUME A SIGNIFICANT LEADERSHIP ROLE IN ADDRESSING THE PRIORITIES IDENTIFIED IN THE CHNA. WE ARE FORTUNATE TO WORK COLLABORATIVELY WITH MANY COMMUNITY ORGANIZATIONS. BERKSHIRE MEDICAL CENTER HAS A STRONG REPUTATION AS A LEADER AND COLLABORATOR IN MEETING COMMUNITY HEALTH NEEDS THROUGH ITS ONGOING COMMUNITY BENEFIT PROGRAMS AND SERVICES. BMC PLANS TO PROVIDE COMMUNITY BENEFIT PROGRAMS IN RESPONSE TO THE HEALTH NEEDS IDENTIFIED IN THE 2021-2024 COMMUNITY HEALTH NEEDS ASSESSMENT. THESE INCLUDE, BUT ARE NOT LIMITED TO, HEALTH EDUCATION PROGRAMS, SCREENINGS, SUPPORT GROUPS, MENTAL HEALTH SERVICES, AND OTHER COMMUNITY HEALTH IMPROVEMENT SERVICES AND ACCESS TO CARE THROUGH SEVERAL LEVERAGED SOURCES (GRANTS). BMC UNDERSTANDS THAT THE NEEDS OF THE COMMUNITY ARE FLUID AND MAY CHANGE WITH CIRCUMSTANCE AND TIME, IN RESPONSE STRATEGIES MAY ALSO CHANGE, AND PROGRAMS MAY BE ADDED OR ELIMINATED DURING THE 2021-2024 TIMEFRAME. LISTED BELOW ARE THE HOSPITAL'S FY21 STRATEGIC PRIORITY HEALTH NEEDS, AND HOW EACH IS ADDRESSED. THE FY21 PRIORITY HEALTH NEEDS ARE UPDATED FROM THE TRIANNUAL FY21 CHNA. BMC HAS IDENTIFIED THE FOLLOWING PRIORITY NEEDS AREAS: BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER, CHRONIC CONDITIONS AND INFECTIOUS DISEASE, ACCESS TO CARE, SOCIAL ECONOMIC, AND WORKFORCE DEVELOPMENT. THESE PRIORITY NEEDS ARE LISTED BELOW WITH SUPPLEMENTATION OF WHAT IS BEING DONE BY THE HOSPITAL REGARDING EACH NEED. PLEASE NOTE, THE LISTS ARE NOT EXHAUSTIVE BUT ARE INTENDED TO PROVIDE AN OVERVIEW. BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER:SUBSTANCE USE/ OPIOIDS - BMC HAS INPATIENT SUBSTANCE USE TREATMENT PROGRAMS, INCLUDING THE MCGEE RECOVERY CENTER, A DETOX PROGRAM, AND OUR CLINICAL STABILIZATION SERVICES UNIT, WHICH GIVES THOSE IN RECOVERY THE OPPORTUNITY TO STAY, UP TO 30 DAYS, IN A SAFE SETTING THAT AIDS IN LONG-TERM RECOVERY. BMC ALSO PARTNERS WITH THE BRIEN CENTER FOR SUBSTANCE USE SERVICES IN PROVIDING ACCESS TO OUTPATIENT PROGRAMS TO ENHANCE TREATMENT FOR ADDICTION. THE SUBSTANCE USE TREATMENT CLINIC DEVELOPED IN 2019 IS PROVIDED BY A MEDICATION ASSISTED TREATMENT (MAT) CERTIFIED NURSE PRACTITIONER AND REGISTERED NURSE WHO PROVIDE TREATMENTS RELATED TO ALL FORMS OF SUBSTANCE USE DISORDERS AND PRACTICE USING THE HARM REDUCTION MODEL OF CARE. CARE INCLUDES SUPPORT, MEDICATIONS INCLUDING INDUCTIONS, ORAL, SUBLINGUAL, INJECTABLE AND TRANSDERMAL FORMULATIONS. COORDINATES CARE WITH THE PATIENT'S PRIMARY CARE PHYSICIAN AND SOCIAL SERVICES. THE GOAL OF THE PROGRAM IS TO HELP MANAGE THEIR SUBSTANCE USE DISORDER, REDUCE EMERGENCY DEPARTMENT UTILIZATION, AND REDUCE INPATIENT AND OBSERVATION ADMISSIONS. THE PROVIDERS ARE BOTH CERTIFIED RECOVERY COACHES. RECRUITMENT FOR OTHER POSITIONS SUCH AS COMMUNITY HEALTH WORKER/RECOVERY COACH AND MEDICAL ASSISTANT HAS BEEN CHALLENGING. MENTAL HEALTH-DEPRESSION, SUICIDE - THE BMC DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL HEALTH PROVIDES ANNUAL FREE DEPRESSION SCREENINGS IN THE COMMUNITY, PARTNERS WITH THE BRIEN CENTER FOR MENTAL HEALTH AND SUBSTANCE USE SERVICES ON OUTPATIENT PROGRAMS AND PROVIDES AN EMPLOYEE ASSISTANCE PROGRAM TO COMPANIES IN THE COMMUNITY TO AID IN RESPONDING TO MENTAL HEALTH ISSUES. CHRONIC CONDITIONS & INFECTIOUS DISEASECANCER - IN ADDITION TO PROVIDING COMPREHENSIVE HEMATOLOGY AND RADIATION ONCOLOGY SERVICES THROUGH THE BMC CANCER CENTER, BMC HAS COMMUNITY PROGRAMS ENCOURAGING AND PROMOTING CANCER SCREENING, SUCH AS COLONOSCOPY, MAMMOGRAPHY, AND LUNG CANCER. FOR COLONOSCOPY AND MAMMOGRAPHY, BMC ALSO PROVIDES PATIENT ASSISTANCE FUNDS TO HELP THOSE AT RISK TO PAY FOR POTENTIAL HIGH CO-PAYS FOR THESE PREVENTION SCREENINGS. CARDIOVASCULAR HEALTH - BERKSHIRE MEDICAL CENTER PROVIDES COMPREHENSIVE CARDIOVASCULAR HEALTH SERVICES THROUGH OUR PHYSICIAN PRACTICES. THE WELLNESS AT WORK PROGRAM PROVIDES CARDIOVASCULAR SCREENINGS FOR BUSINESSES AND EMPLOYEES. AS WELL AS FREE COMMUNITY BLOOD PRESSURE SCREENINGS. DIABETES - BMC HAS A DIABETES EDUCATION PROGRAM THAT WORKS WITH PEOPLE DIAGNOSED WITH PRE-DIABETES, AND TYPE 1 AND 2 DIABETES, PROVIDING ONE-ON-ONE COUNSELING AND SUPPORT, INCLUDING ACCESS TO NUTRITION SERVICES. INFECTIOUS DISEASE - BMC'S INFECTION PREVENTION AND CONTROL DEPARTMENT WORKS BOTH IN THE HOSPITAL AND IN THE COMMUNITY TO CURB INFECTIOUS DISEASE, INCLUDING COVID-19, INFLUENZA, LYME DISEASE, AND MANY OTHERS. STROKE/BLOOD PRESSURE - BMC IS A DEDICATED STROKE CENTER AND REGULARLY PROVIDES COMMUNITY LECTURES AND PROGRAMS THAT EDUCATE RESIDENTS ON THE RISK FACTORS AND WARNING SIGNS FOR STROKE, AND HOW TO RESPOND. SEXUALLY TRANSMITTED DISEASE/ INFECTION - BMC'S INFECTION PREVENTION AND CONTROL DEPARTMENT WORKS BOTH IN THE HOSPITAL AND IN THE COMMUNITY TO CURB INFECTIOUS DISEASE, INCLUDING INFLUENZA, LYME DISEASE, AND MANY OTHERS. BERKSHIRE HARM REDUCTION PROGRAM EMBRACES AN APPROACH THAT FOCUSES ON HELPING PEOPLE WHO USE DRUGS REDUCE THEIR HIGH-RISK BEHAVIOR AND THE HARM ASSOCIATED WITH DRUG USE.CONTINUE ON SCHEDULE O

PART V, SECTION B LINE 7A
THE HOSPITAL'S 2021 CHNA REPORT IS AVAILABLE ON THE HOSPITAL WEBSITE, HTTPS://WWW.BERKSHIREHEALTHSYSTEMS.ORG/PROGRAMS-AND-SERVICES/COMMUNITY-WELLNESS/CLICK ON THE LINK FOR COMMUNITY BENEFIT REPORT BMC FY 2021

PART V SECTION B LINE 10A
THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE ON THE HOSPITAL WEBSITE,HTTPS://WWW.BERKSHIREHEALTHSYSTEMS.ORG/PROGRAMS-AND-SERVICES/COMMUNITY-WELLNESS/CLICK ON THE LINK FOR COMMUNITY BENEFIT REPORT BMC FY 2021.

PART V SECTION B LINE 16A
"THE HOSPITAL'S FAP IS AVAILABLE ON THE HOSPITAL WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/ABOUT/POLICIES-AND-NOTICES, SELECT FINANCIAL ASSISTANCE POLICY DROP DOWN BOX, SELECT DOCUMENT ""FINANCIAL ASSISTANCE POLICY - BERKSHIRE HEALTH SYSTEMS""."

PART V SECTION B LINE 16B
"THE HOSPITAL'S FAP APPLICATION IS AVAILABLE ON THE HOSPITAL WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/ABOUT/POLICIES-AND-NOTICES, SELECT FINANCIAL ASSISTANCE POLICY DROP DOWN BOX, THEN SELECT THE DOCUMENT ""FINANCIAL ASSISTANCE APPLICATION""."

PART V SECTION B LINE 16C
"THE HOSPITAL'S PLAIN LANGUAGE SUMMARY OF THE FAP IS AVAILABLE ON THE HOSPITAL WEBSITE, WWW.BERKSHIREHEALTHSYSTEMS.ORG/ABOUT/POLICIES-AND-NOTICES, SELECT FINANCIAL ASSISTANCE POLICY DROP DOWN BOX, THEN SELECT THE DOCUMENT ""PLAIN LANGUAGE SUMMARY OF FINANCIAL ASSISTANCE POLICIES""."

PART I, LINE 7:
THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINES 7A, 7B, & 7C HAS BEEN CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AS COMPUTED USING WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. THE TOTAL COMMUNITY BENEFIT EXPENSE REPORTED ON PART I, LINE 7G HAS BEEN CALCULATED USING A COST ACCOUNTING METHOD.

PART I, LINE 7G:
OUR COMMUNITY BENEFITS WHICH ARE SUBSIDIZED ARE THE SUBSTANCE ABUSE UNIT, CLINICAL STABILIZATION SERVICES, RENAL DIALYSIS SERVICES, AND THE INPATIENT PYSCHIATRIC UNIT.

PART I, LN 7 COL(F):
BAD DEBT EXPENSE OF $9,635,237 ATTRIBUTABLE TO PATIENT ACCOUNTS HAS BEEN EXCLUDED FROM THE COMPUTATION OF ALL COMMUNITY BENEFIT EXPENSE SHOWN IN PART I, LINE 7, COLUMN F.

PART I, LINE 6A
FAIRVIEW HOSPITAL AND BERKSHIRE MEDICAL CENTER EACH FILE A SEPARATE COMMUNITY BENEFITS REPORT WITH THE STATE OF MASSACHUSETTS. BMC'S FISCAL YEAR 2021 COMMUNITY BENEFITS REPORT CAN BE ACCESSED AT HTTPS://MASSCHARITIES.MY.SITE.COM/FILINGSEARCH/S/DETAIL/A095E000009HDTMAA0

PART II, COMMUNITY BUILDING ACTIVITIES:
WORKFORCE DEVELOPMENT $493,964: RECRUITMENT OF STAFF

PART III, LINE 2:
THE HOSPITAL REPORTS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE AMOUNTS BASED UPON ACTUAL WRITE-OFF'S, A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS AND TRENDS.

PART III, LINE 4:
"FOOTNOTE 2 (PROVISION FOR BAD DEBT) TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SUPPLEMENTARY FINANCIAL INFORMATION OF BERKSHIRE HEALTH SYSTEMS, INC. AND AFFILIATES (INCLUDING BERKSHIRE MEDICAL CENTER) FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021 ARE LISTED ON PAGE 13 UNDER ""PATIENT ACCOUNTS RECEIVABLE""."

PART III, LINE 8:
THE AMOUNT REPORTED ON LINE 6, PART III WAS DETERMINED USING THE COST ALLOCATION METHODOLOGY USED FOR THE MEDICARE COST REPORTS. THE LOSS ON MEDICARE ACTIVITY AS REPORTED IN PART III, LINE 7 IS A COMMUNITY BENEFIT BECAUSE IT IS THE MISSION OF BERKSHIRE MEDICAL CENTER TO PROVIDE HIGH QUALITY HEALTH CARE TO RESIDENTS OF BERKSHIRE COUNTY REGARDLESS OF THEIR ABILITY TO PAY. THE COST TO PROVIDE SERVICES TO MEDICARE BENEFICIARIES OFTEN EXCEEDS THE REIMBURSEMENT FOR SUCH SERVICES. ELDERLY PATIENTS ARE AMONG THE MOST NEEDY IN OUR COMMUNITY AND PROVIDING SERVICES TO THEM CLOSE TO HOME IMPROVES THE QUALITY OF THEIR CARE, INCREASES ACCESS AND ENHANCES HEALTH AND WELLNESS FOR THIS POPULATION. SERVICES SUCH AS EMERGENCY CARE, CARDIAC SERVICES, PSYCHIATRIC CARE, RENAL DIALYSIS AND WOUND CARE SERVICES ARE AMONG THOSE THAT PROVIDE A SIGNIFICANT BENEFIT TO THE FRAIL ELDERLY. THE BREADTH OF ACUTE AND AMBULATORY SERVICES PROVIDED BY BMC MEANS THAT THE MEDICARE BENEFICIARIES IN OUR COUNTY DO NOT HAVE TO LEAVE THE COUNTY FOR MOST SERVICES.

PART III, LINE 9B:
"POPULATIONS EXEMPT FROM COLLECTION ACTIVITIESTHE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS:A. PATIENTS ENROLLED IN A STATE HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN, ""LOW INCOME PATIENTS"" AS DETERMINED BY THE OFFICE OF MEDICAID.1. PLEASE NOTE THAT BMC MAY SEEK COLLECTION ACTION AGAINST ANY PATIENT ENROLLED IN THE ABOVE MENTIONED PROGRAMS FOR THEIR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM.2. BMC MAY ALSO INITIATE BILLING OR COLLECTION FOR A PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT FAILS TO PROVIDE PROOF OF SUCH PARTICIPATION. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM, (INCLUDING RECEIPT OR VERIFICATION OF SIGNED APPLICATION) BMC SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES. 3. BMC MAY CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED OR EXPIRED. HOWEVER, ONCE A PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN COMMONWEALTH CARE PROGRAMS, BMC WILL CEASE COLLECTION ACTIVITY FOR SERVICES, PREVIOUSLY BILLED, THAT NOW FALL INTO THE ELIGIBILITY PERIOD. 4. BMC MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE.5. BMC WILL NOT UNDERTAKE COLLECTION ACTION AGAINST AN INDIVIDUAL THAT HAS BEEN APPROVED FOR MEDICAL HARDSHIP UNDER THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM WITH RESPECT TO THE AMOUNT OF THE BILL THAT EXCEEDS THE MEDICAL HARDSHIP CONTRIBUTION.B. BMC DOES NOT GARNISH A PATIENT'S OR THE PATIENT'S GUARANTOR'S WAGES OR EXECUTE A LIEN ON THE PATIENT'S OR THE PATIENT'S GUARANTOR'S PERSONAL RESIDENCE OR MOTOR VEHICLE. C. BMC AND ITS AGENTS SHALL NOT CONTINUE COLLECTION OR BILLING ON A PATIENT WHO IS A MEMBER OF A BANKRUPTCY PROCEEDING EXCEPT TO SECURE ITS RIGHTS AS A CREDITOR IN THE APPROPRIATE ORDER."

PART VI, LINE 7, REPORTS FILED WITH STATES
MA

PART VI, LINE 2:
"COMMUNITY BENEFITS MISSION STATEMENT:FURTHERING OUR CHARITABLE PURPOSE, THE BERKSHIRE MEDICAL CENTER'S (BMC) COMMUNITY BENEFIT MISSION IS TO IDENTIFY, PRIORITIZE AND INVEST IN OUR COMMUNITY'S HEALTH NEEDS BY PURSUING NEEDED INITIATIVES AND PROGRAMS. THE COMMUNITY BENEFIT GOALS INCLUDE SATISFYING UNMET NEEDS IN THE BERKSHIRES AND IMPROVING THE HEALTH STATUS OF OUR COMMUNITY WITH A PARTICULAR FOCUS ON ACCESS TO HEALTHCARE AND ""AT RISK"" POPULATIONS. RECOGNIZING THE VALUE OF BMC'S PARTNERSHIP WITH OUR COMMUNITY, BMC WILL SEEK INPUT AND MEANINGFUL COLLABORATION IN OUR EFFORT TO MEET COMMUNITY NEED. BMC WILL OUTLINE IN AN ANNUAL COMMUNITY BENEFIT PLAN, THE PRIORITIES TO BE ADDRESSED AND THE INITIATIVES TO BE FUNDED.BMC AND FAIRVIEW HOSPITAL ARE BOTH PART OF BERKSHIRE HEALTH SYSTEMS AND THEREFORE WORK TOGETHER TO MEET COMMUNITY NEED. COMMUNITY BENEFIT AND ACCESS COMMITTEE:AS A STANDING COMMITTEE OF THE BOARD OF TRUSTEES - ITSELF MADE UP OF COMMUNITY VOLUNTEERS, THIS COMMITTEE IS RESPONSIBLE FOR UNDERSTANDING THE HEALTH NEEDS AND BARRIERS TO CARE IN OUR SERVICE AREA. THE COMMITTEE OVERSEES THE COMMUNITY BENEFIT PROCESS OF THE ORGANIZATION, INCLUDING HEALTH NEEDS ASSESSMENTS, DETERMINING TARGET POPULATIONS AND PRIORITIES, DEVELOPMENT OF THE COMMUNITY BENEFITS PLAN AND EVALUATING PERFORMANCE AGAINST GOALS AND OBJECTIVES. THE COMMITTEE IS COMPRISED OF PEOPLE FROM THE BOARD OF TRUSTEES AND THE COMMUNITY AT LARGE AND MEETS MONTHLY THOUGH OUT THE YEAR. COMMUNITY BENEFITS LEADERSHIP/TEAM:THE BHS COMMUNITY BENEFITS AND ACCESS COMMITTEE MEETS TO DISCUSS COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, COMMUNITY NEEDS AND OUTCOMES. IN 2021 THE COMMUNITY BENEFIT AND ACCESS COMMITTEE DID NOT MEET DUE TO THE COVID-19 PANDEMIC. COMMUNITY BENEFITS MEETINGS:THE BHS COMMUNITY BENEFITS AND ACCESS COMMITTEE MEETS TO DISCUSS COMMUNITY BENEFIT PROGRAMS, POTENTIAL NEW INITIATIVES, COMMUNITY NEEDS AND OUTCOMES. IN 2022 THE COMMUNITY BENEFIT AND ACCESS COMMITTEE DID NOT MEET DUE TO THE COVID-19 PANDEMIC. THE COMMUNITY BENEFIT AND ACCESS COMMITTEE IS CURRENTLY BEING RESTRUCTURED. COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)BMC HAS UTILIZED AN ACTIVE COMMUNITY NEEDS ASSESSMENT AS PART OF ITS COMMUNITY BENEFIT PROCESS SINCE 1996. THE COMMUNITY NEEDS ASSESSMENT IS UPDATED ANNUALLY, WITH A COMPLETE ASSESSMENT DONE EVERY THREE YEARS. THE LAST CHNA WAS COMPLETED IN THE FALL OF 2021. BMC UTILIZED ALL AVAILABLE CLINICAL, HEALTH STATUS, DEMOGRAPHIC, AND SOCIO-ECONOMIC DATA AVAILABLE TO FORM THE FOUNDATION OF OUR NEEDS ASSESSMENT. IN ADDITION, WE GATHERED AVAILABLE QUALITATIVE DATA FROM OUR MANY ADVISORY GROUPS, COMMUNITY FORUMS, SURVEYS, AND FOCUS GROUPS. THE WELLNESS AND OUTREACH PROGRAMS ALSO SUPPLEMENT OUR UNDERSTANDING OF THE HEALTH STATUS OF OUR COMMUNITY, HEALTH RISK FACTORS, AND BARRIERS TO HEALTH AND HEALTH CARE. THE FEEDBACK GATHERED INPUT ON SPECIFIC ACTIONS THAT COULD BE TAKEN AT AN INDIVIDUAL, FAMILY, AND ORGANIZATIONAL LEVEL AS WELL AS IDENTIFYING GAPS IN SERVICE IN ADDITION TO PRIORITIZING THE MOST IMPORTANT NEEDS FOR THE COMMUNITY. WE HAVE CONVENED THIS COMMUNITY GROUP AT LEAST ANNUALLY TO REVIEW DATA, CONFIRM PRIORITIES, DISCUSS NEEDS, AND WORK TOGETHER TO ADDRESS THE IDENTIFIED PRIORIES AND NEEDS. THE NEEDS DATA, ALONG WITH STATE PRIORITIES ARE USED TO DETERMINE OUR ANNUAL COMMUNITY BENEFIT PRIORITIES. IN ITS PLANNING, BMC LOOKS FOR OPPORTUNITIES TO MAKE BETTER AND MORE EFFECTIVE USE OF EXISTING RESOURCES AND PROVIDERS, AS WELL AS TO IDENTIFY GAPS IN SERVICE AND SEEKS OUT AVAILABLE GRANTS TO FACILITATE MEETING COMMUNITY NEED. BMC WORKS WITH INTERNAL RESOURCES AND COMMUNITY AND REGIONAL PARTNERS, WITH THE HELP OF EVIDENCED BASED OR BEST PRACTICE PROGRAMS, TO DEVELOP AND IMPLEMENT PROGRAMS AND INITIATIVES TO MEET COMMUNITY NEED. DATA SOURCESCOMMUNITY FOCUS GROUPS, HOSPITAL DATA, CONSUMER AND ADVISORY GROUPS, INTERVIEWS, MASS CHIP, PUBLIC HEALTH PERSONNEL, SURVEYS, OTHER - HEALTHYPEOPLE.GOV; DEPARTMENT OF PUBLIC HEALTH BUREAU OF FAMILY AND COMMUNITY HEALTH INJURY REPORT; COUNTY HEALTH RANKINGS, DEPARTMENT OF PUBLIC HEALTH PRESCRIPTION MONITORING PROGRAM DATA; PHYSICIAN MANPOWER DATA; WORKFORCE NEEDS DATA; WELLNESS AT WORK DATA; EMERGENCY DEPARTMENT/TRAUMA REGISTRY; BERKSHIRE UNITED WAY; NORTHERN BERKSHIRE COMMUNITY COALITION, BERKSHIRE REGIONAL PLANNING COMMISSION; AND YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM DATA. GOALS: STATEWIDE PRIORITIES AS PART OF OUR PLANNING PROCESS, BHS INCORPORATES THE MASSACHUSETTS STATEWIDE PRIORITIES AND THE MA DEPARTMENT OF PUBLIC HEALTH PRIORITIES TO GUIDE THE INVESTMENTS FUNDED BY THE DETERMINATION OF NEED PROCESS AS PART OF OUR LOCAL ASSESSMENT, PRIORITIES AND INITIATIVES. THE COMMONWEALTH'S PRIORITIES ARE: CHRONIC DISEASE (WITH A FOCUS ON CANCER, HEART DISEASE, & DIABETES), HOUSING STABILITY/HOMELESSNESS, MENTAL ILLNESS & MENTAL HEALTH, AND SUBSTANCE USE DISORDERS. THE DEPARTMENT OF PUBLIC HEALTH'S PRIORITIES ARE: BUILT ENVIRONMENT, SOCIAL ENVIRONMENT, HOUSING, VIOLENCE, EDUCATION AND EMPLOYMENT COMMUNITY BENEFIT TARGET POPULATIONS:CHILDREN/ADOLESCENTS OLDER ADULTS MEDICALLY UNDERSERVED COMMUNITY BENEFIT PRIORITIES:BEHAVIORAL HEALTH & SUBSTANCE USE DISORDER CHRONIC CONDITIONS & INFECTIOUS DISEASE ACCESS TO CARE SOCIAL ECONOMIC WORKFORCE DEVELOPMENT COMMUNITY PARTNERSBEACON RECOVERY COMMUNITY CENTER, BERKSHIRE AHEC, BERKSHIRE BOUNTY, BERKSHIRE BREAST HEALTH TEAM, BERKSHIRE COMMUNITY ACTION COUNCIL, BERKSHIRE COMMUNITY PROVIDERS, BERKSHIRE COUNTY BOARDS OF HEALTH, BERKSHIRE COUNTY COURT SYSTEM, BERKSHIRE COUNTY FIRE DEPARTMENTS, BERKSHIRE COUNTY REGIONAL EMERGENCY OPERATIONS PLANNING COMMITTEE, BERKSHIRE COUNTY REGIONAL HOUSING AUTHORITY, BERKSHIRE COUNTY REGIONAL PLANNING COMMISSION, BERKSHIRE COUNTY SHERIFF'S OFFICE, BERKSHIRE DISTRICT ATTORNEY OFFICE, BERKSHIRE EMERGENCY NURSE'S ASSOCIATION, BERKSHIRE FACILITIES SERVICES, BERKSHIRE FALLON HEALTH COLLABORATIVE, BERKSHIRE IMMIGRANT CENTER, BERKSHIRE OB-GYN, BERKSHIRE OPIOID ADDICTION PREVENTION COLLABORATIVE (BOAPC), BERKSHIRE UNITED WAY, BERKSHIRE YOUTH DEVELOPMENT PROJECT, BOARDS OF HEALTH: TRI-TOWN HEALTH DEPARTMENT, BERKSHIRE COUNTY BOARDS OF HEALTH AND PITTSFIELD HEALTH DEPARTMENT, THE BRIEN CENTER FOR MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES, CHILD CARE OF THE BERKSHIRES, CLINICAL SUPPORT OPTIONS, COMMUNITY HEALTH PROGRAMS, EDUCATIONAL INSTITUTIONS (LOCAL SCHOOL DISTRICTS, BERKSHIRE COMMUNITY COLLEGE, MASSACHUSETTS COLLEGE OF LIBERAL ARTS, WILLIAMS COLLEGE, UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL), ELDER SERVICES OF BERKSHIRE COUNTY/ SENIOR CENTERS/COUNCILS ON AGING/RVSP/SHINE, FOOD BANK OF WESTERN MA, GREYLOCK FEDERAL CREDIT UNION, HOME-CARE AGENCIES, INNOVATIVE CARE PARTNERS, JUVENILE AND ADULT PROBATION, KEENAN HOUSE, LOCAL BUSINESS COMMUNITY, LOCAL EMERGENCY MANAGEMENT SERVICES/PITTSFIELD POLICE DEPARTMENT, LOCAL HIRING AGENCIES, LOCAL SHELTERS, FOOD PANTRIES, DAY PROGRAMS, ETC., MCGEE RECOVERY CENTER, MOTHER'S IN RECOVERY, NORTHERN BERKSHIRE COMMUNITY COALITION, PHYSICIAN AND SPECIAL PROVIDER OFFICES, RECREATIONAL (BERKSHIRE BOYS AND GIRLS CLUB, BERKSHIRE FAMILY YMCA, BERKSHIRE SOUTH), REGIONAL PAIN COLLABORATIVE, SERVICENET, THINK FIRST, VOLUNTEERS IN MEDICINE, WIC (WOMEN, INFANTS, AND CHILDREN), ZERO SUICIDEPROGRAM PLANNING AND EVALUATIONTHE COMMUNITY HEALTH NEEDS ASSESSMENT IS USED TO FOCUS OUR COMMUNITY BENEFIT PROGRAM AND INITIATIVE PLANNING AS WELL AS TO MONITOR RESULTS AND REPRIORITIZE FOR FUTURE EFFORTS."

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BMC PROMINENTLY ADVERTISES THROUGHOUT THE COMMUNITY, AT ALL OF ITS FACILITIES, AND ON ITS WEBSITE ITS ADVOCACY FOR ACCESS PROGRAM. THE GOAL OF THIS PROGRAM IS TO ASSIST THE UNINSURED AND UNDERINSURED IN BERKSHIRE COUNTY IN ACCESSING VARIOUS FEDERAL, STATE, OR LOCAL PROGRAMS THAT CAN PAY FOR HEALTHCARE SERVICES, AS WELL AS INFORM PATIENTS ABOUT OTHER AVENUES THEY CAN ACCESS TO RECEIVE HEALTHCARE SERVICES AT NO COST. ADVOCACY FOR ACCESS HELPS REDUCE THE PERCEPTION THAT AN INABILITY TO PAY FOR HEALTHCARE IS A BARRIER TO RECEIVING CARE. ADVOCACY FOR ACCESS STAFF FACILITATE THE APPLICATION AND ENROLLMENT PROCESS OF INDIVIDUALS AND FAMILIES WHO LIVE IN MASSACHUSETTS INTO QUALIFIED HEALTH PLANS THROUGH THE MARKETPLACE AND/OR OTHER HEALTH INSURANCE PROGRAMS SUCH AS MEDICAID AND CHIP, AND ASSIST QUALIFIED INDIVIDUALS IN MAKING INFORMED DECISIONS ON THE SELECTION OF A HEALTH PLAN. THE STAFF RECOGNIZES THAT MANY OF THESE STATE AND FEDERAL PROGRAMS CAN BE COMPLEX AND CONFUSING, AND THEIR GOAL IS TO MAKE THE HEALTH INSURANCE ENROLLMENT PROCESS AS SIMPLE AS POSSIBLE FOR THE PATIENT. WHEN AN INDIVIDUAL OR FAMILY'S CIRCUMSTANCES CHANGE, THE ADVOCACY STAFF CAN ASSIST IN UPDATING THE APPROPRIATE AGENCY.ADVOCACY FOR ACCESS ASSISTS THOUSANDS OF PEOPLE EACH YEAR ACCESS HEALTH INSURANCE OR OTHER COVERAGE PROGRAMS TO AID THEM IN ADDRESSING THEIR HEALTHCARE NEEDS.IN ADDITION TO THE ADVOCACY FOR ACCESS PROGRAM, BERKSHIRE HEALTH SYSTEMS HAS AN INTERNAL FINANCIAL ASSISTANCE PROGRAM THAT IS AVAILABLE TO UNINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC ASSISTANCE THROUGH THE STATE OR WHO ARE NOT MASSACHUSETTS RESIDENTS.INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS IS OFFERED TO OUR PATIENTS IN THE FOLLOWING MANNER:NOTICES OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS ARE POSTED THROUGHOUT THE HOSPITAL, SPECIFICALLY IN ALL SERVICE DELIVERY AREAS, IN FINANCIAL COUNSELING OFFICES THROUGHOUT THE CLINICAL CAMPUSES, IN ALL BERKSHIRE FACULTY SERVICES PHYSICIAN PRACTICES, AND ELECTRONICALLY ON BMC'S WEBSITE WWW.BERKSHIREHEALTHSYSTEMS.ORG. APPOINTMENTS CAN BE MADE WITH THE ADVOCACY FOR ACCESS APPLICATION COUNSELORS WHO CAN ASSIST PATIENTS SUBMIT AN ELECTRONIC APPLICATION VIA WWW.MAHEALTHCONNECTOR.ORG FOR STATE FINANCIAL ASSISTANCE PROGRAMS. APPLICATION COUNSELOR ARE ALSO AVAILABLE DAILY TO MEET WITH PATIENTS WHO PRESENT AT THE OFFICE WITHOUT AN APPOINTMENT.AT PRE-REGISTRATION, SELF-PAY PATIENTS ARE OFFERED AN APPOINTMENT WITH THE ADVOCACY FOR ACCESS PROGRAM OFFICE ALONG WITH AN EXPLANATION OF THE SERVICE.BROCHURES ARE DISTRIBUTED AT ALL ACCESS POINTS INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS WITH PHONE NUMBERS TO CONTACT ADVOCACY FOR ACCESS TO SET UP AN APPOINTMENT. STATEMENTS MAILED TO PATIENTS WHO HAVE A SELF-PAY BALANCE WILL HAVE A MESSAGE INDICATING THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE AND THE PHONE NUMBERS TO CONTACT ADVOCACY FOR ACCESS FOR ADDITIONAL INFORMATION. ALL PATIENT STATEMENTS HAVE A MESSAGE ON THE BACK OF THE STATEMENT INDICATING THE AVAILABILITY OF FINANCIAL ASSISTANCE.

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BMC IS A PART OF AN INTEGRATED, NON-PROFIT HEALTHCARE SYSTEM THAT INCLUDES (A) A TEACHING HOSPITAL, (B) A CRITICAL ACCESS COMMUNITY HOSPITAL, (C) A LARGE, MULTISPECIALTY FACULTY PRACTICE ORGANIZATION, (D) A HOME HEALTH AGENCY AND (E), BY CONTRACT AND CLOSE COORDINATION, A NON-PROFIT SENIOR CARE ORGANIZATION THAT INCLUDES SUB-ACUTE SERVICES IN REHABILITATION AND LONG TERM CARE FACILITIES, ASSISTED LIVING FACILITIES, HOSPICE CARE SERVICES, SENIOR DAY CARE AND OTHER ELDERCARE SERVICES. BMC ENGAGES IN HEALTHCARE NEEDS ASSESSMENT AND PLANNING ON A SYSTEM-WIDE BASIS, WITH A GOAL OF A SEAMLESS TRANSITION OF PATIENT-CENTERED CARE ACROSS THE SPECTRUM OF SERVICES OFFERED BY EACH OF THE SYSTEM'S COMPONENT ENTITIES. BMC, ALONG WITH ITS AFFILIATES, CONTINUES TO DEVELOP INTEGRATED CLINICAL AND INFORMATION SYSTEMS ACROSS THE ENTIRE ORGANIZATION SO AS TO RENDER CARE EFFICIENTLY, EFFECTIVELY AND CONSISTENTLY AT EVERY CARE SITE. THE BMC AFFILIATES SUCH, AS THE PHYSICIAN FACULTY PRACTICE, ARE FULLY INTEGRATED INTO OUR COMMUNITY BENEFIT PROCESS AND SUPPORT THE ORGANIZATION'S PRIORITIES BY HONORING OUR FREE CARE GUIDELINES AND IN ENGAGING IN SPECIFIC PROGRAMS AND INITIATIVES DESIGNED TO MEET COMMUNITY NEED.

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BERKSHIRE COUNTY IS THE MOST WESTERN OF THE 14 COUNTIES IN MASSACHUSETTS. WITH ABOUT 12% OF THE TOTAL LAND MASS IN MASSACHUSETTS, AND ONLY 2% OF THE POPULATION, BERKSHIRE COUNTY IS THE SECOND MOST RURAL COUNTY IN THE STATE. THE BERKSHIRES RUN ALONG THE NEW YORK BORDER FROM VERMONT IN THE NORTH TO CONNECTICUT IN THE SOUTH AND ENCOMPASSES MOST OF THE MOUNTAIN RIDGE THAT SEPARATES THE HUDSON AND CONNECTICUT RIVER VALLEYS. ELEVATIONS RANGE FROM 500 FEET IN THE RIVER VALLEYS TO 3500 FEET AT MOUNT GREYLOCK.THE SOCIODEMOGRAPHIC CHARACTERISTICS OF BERKSHIRE COUNTY:SEX AND AGE TOTAL POPULATION 125,927 MALE 48.5% FEMALE 51.5%MEDIAN AGE (YEARS) 47.2 YRS. UNDER 5 YEARS 4.2% 5-19 YEARS 15.7% 20-64 YEARS 56.9% 65 YEARS AND OVER 23.2%RACE AND ETHNICITY ONE RACE 96.3% WHITE 89.9% BLACK OR AFRICAN AMERICAN 2.7% AMERICAN INDIAN AND ALASKA NATIVE 0.3% ASIAN 1.7% NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER 0.0% SOME OTHER RACE 1.6%TWO OR MORE RACES 3.7%HISPANIC OR LATINO (OF ANY RACE) 5.0% NOT HISPANIC OR LATINO 95.0% NOT HISPANIC OR LATINO, WHITE ALONE 87.7%THE COUNTY IS COMPRISED OF THREE DISTINCT SUB-REGIONS: NORTH, SOUTH, AND CENTRAL WHICH FORM THE OVERALL COUNTY PROFILE OF A LARGELY RURAL AREA WITH SMALL URBAN, AGRARIAN, AND POST-INDUSTRIAL TOWNS AND CITIES. WHILE TIED TOGETHER ECONOMICALLY, SOCIALLY, AND POLITICALLY, EACH SUB-REGION REFLECTS A DEGREE OF SOCIAL AND ECONOMIC DIFFERENCES, PRIMARILY DUE TO THE 50-MILE LENGTH OF THE COUNTY FROM NORTH TO SOUTH. BERKSHIRE COUNTY'S POPULATION, ACCORDING TO THE 2020 CENSUS, IS 129,026, WITH POPULATION LARGELY CONCENTRATED IN THE COUNTY'S TWO CITIES-PITTSFIELD (43,927) AND NORTH ADAMS (12,961).SINCE THE CLOSURE OF THE FORMER NORTH ADAMS REGIONAL HOSPITAL IN 2014, BERKSHIRE MEDICAL CENTER AND BERKSHIRE HEALTH SYSTEMS STABILIZED ACCESS TO CRITICAL SERVICES FIRST AND THEN PROCEEDED TO ADD ADDITIONAL SERVICES TO MEET COMMUNITY NEED AND ACCESS EFFORTS. THIS WORK CONTINUES AND HAS BEEN SUPPORTED WITH THE HELP OF MANY LOCAL ORGANIZATIONS, ELECTED OFFICIALS, AND GOVERNMENT AGENCIES. THE BERKSHIRES IS A NATIONALLY RECOGNIZED YEAR-ROUND TOURIST DESTINATION, KNOWN FOR ITS CULTURAL OFFERINGS AND OUTDOOR RECREATION. BOASTING AWARD-WINNING ART MUSEUMS, HISTORICAL DESTINATIONS, AND THEATRES ALONGSIDE SCENIC HIKING, BIKING, AND SKIING, THE BERKSHIRES HAS BEEN A HOLIDAY DESTINATION FOR BOSTON AND NEW YORK RESIDENTS FOR HUNDREDS OF YEARS AND IS HOME TO MANY SEASONAL RESIDENTS. THE COUNTY IS TRADITIONALLY DIVIDED INTO THREE REGIONS: NORTH, CENTRAL, AND SOUTH. IT TAKES ABOUT TWO HOURS TO DRIVE FROM THE TOWN OF SHEFFIELD IN THE SOUTH TO WILLIAMSTOWN IN THE NORTH. THERE IS NO COUNTY GOVERNMENT, AND ALL LOCAL SERVICES ARE THE RESPONSIBILITY OF EACH OF THE COUNTY'S 32 TOWNS AND CITIES. THE COMMONWEALTH OF MASSACHUSETTS FUNDS A COUNTY SHERIFF'S DEPARTMENT, DISTRICT ATTORNEY'S OFFICE, THE COURT SYSTEM, AND REGISTRY OF DEEDS. EACH AREA OF THE COUNTY IS SERVICED BY A REGIONAL EMERGENCY PLANNING COMMITTEE (REPC).BERKSHIRE COUNTY'S POVERTY RATE MIRRORS THAT OF THE STATE, HOWEVER, THE COUNTY HAS A SLIGHTLY INCREASED RATE OF POVERTY AMONG MINORS (UNDER 18 YEARS OLD). MEDIAN HOUSEHOLD INCOME FOR THE REGION IS AT LEAST 25% LOWER THAN THE STATE AVERAGE.POVERTY: PERCENTAGE OF ALL PEOPLE WHOSE INCOME IN THE PAST 12 MONTHS IS BELOW THEPOVERTY LEVEL: BERKSHIRE COUNTY 9.7% MASSACHUSETTS 9.8%POVERTY UNDER 18 YEARS: BERKSHIRE COUNTY 13.9% MASSACHUSETTS 12.2%INCOME: MEDIAN HOUSEHOLD INCOME: BERKSHIRE COUNTY $62,166 MASSACHUSETTS $84,385 MEDIAN NONFAMILY INCOME: BERKSHIRE COUNTY $36,294 MASSACHUSETTS $48,876DATA SOURCE US CENSUS BUREAU,ACS 5-YEAR ESTIMATES, 2020THE EDUCATION PROFILE OF COUNTY RESIDENTS REFLECTS THE ECONOMIC AND POPULATION DEMOGRAPHIC:THE EDUCATION LEVEL OF BERKSHIRE COUNTY RESIDENTS LARGELY MIRRORS THAT OF MASSACHUSETTS, SURPASSING THE STATE IN THE PERCENTAGE OF INDIVIDUALS WHO HAVE GRADUATED FROM HIGH SCHOOL AND HAVE AT LEAST SOME COLLEGE, OR AN ASSOCIATE DEGREE. BERKSHIRE COUNTY HAS A SIGNIFICANTLY SMALLER POPULATION OF BACHELOR'S EDUCATED RESIDENTS THAN THE STATE OVERALL (35.3% VS. 44.5%)A TOTAL OF 7.5% OF INDIVIDUALS OVER THE AGE OF 5 SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THIS FIGURE HAS BEEN RISING CONSISTENTLY, INDICATING THE GROWTH OF IMMIGRANT POPULATIONS. BHS LANGUAGE SERVICE ENCOUNTERS REVEAL A SIMILAR TREND, WITH A HIGHER AVERAGE NUMBER OF REQUESTS FOR LANGUAGE SUPPORT SERVICES IN 2021.THE CONNECTION BETWEEN EDUCATION AND INCOME CAN BE A SIGNIFICANT DETERMINANT IN HEALTH STATUS, AS IT CAN RELATE TO FOOD SECURITY, HOUSING, BEHAVIORAL HEALTH CHOICES, AND GENERAL FEELING OF WELL-BEING. THE CUMULATIVE IMPACT OF THIS TRANSITION HAS HAD A SIGNIFICANT IMPACT ON THE FABRIC OF THE COMMUNITY. TRADITIONAL SUPPORT SYSTEMS OF FAMILY, SCHOOLS, AND RELIGION HAVE BEEN CHALLENGED BY THESE DEVELOPMENTS:ALCOHOL AND DRUG ABUSE ARE SIGNIFICANT ISSUES. COUNTY RESIDENTS ARE ADMITTED INTO SUBSTANCE USE TREATMENT AT A FAR GREATER RATE THAN THE STATE AVERAGE.IN 2016, SUICIDE RATES IN BERKSHIRE COUNTY WERE 11.8 AND CONTINUE TO BE HIGHER THAN THE STATE RATE OF 9.2 PER 100,000 POPULATION. (CHNA)FROM 2012 TO 2016 THE VIOLENT CRIME RATE PER 100,00 POPULATION INCREASED BY 95% IN NORTH ADAMS (705.3 TO 1375.2) AND 85.6% IN PITTSFIELD'S (425.7 TO. 790.1). HOWEVER, DURING THE SAME PERIOD MASSACHUSETTS, OVERALL, HAD A DECREASE OF 7.1% (405.5 TO 376.9). (CITY DATA)COMMUNITY PARTNERS NORTHERN BERKSHIRE COMMUNITY COALITION, THE BERKSHIRE YOUTH DEVELOPMENT PROJECT, BERKSHIRE UNITED WAY, AND THE RAILROAD STREET YOUTH PROJECT WITH THE SUPPORT OF BHS, CONDUCTED A COUNTY-WIDE PREVENTION NEEDS ASSESSMENT SURVEY IN 2021. THERE ARE SOME DIFFERENCES BETWEEN THE COUNTY, FOR EXAMPLE ALCOHOL USE IS MORE LIKELY IN CENTRAL COUNTY AND CIGARETTES ARE MORE LIKELY IN SOUTH COUNTY WHERE SUICIDAL IDEATION IS MORE LIKELY IN NORTH COUNTY. AMONG ADOLESCENTS, ALCOHOL, MARIJUANA, AND TOBACCO APPEAR TO BE THE MOST PREVALENT SUBSTANCES BEING USED. (CHNA) CONTINUED ON SCHEDULE O

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THE GOVERNING BODY OF BERKSHIRE MEDICAL CENTER (BMC) CONSISTS OF COMMUNITY VOLUNTEERS, PHYSICIAN REPRESENTATIVES OF THE HOSPITALS' MEDICAL STAFF AND, AND THE CHIEF EXECUTIVE OFFICER. THE COMMUNITY VOLUNTEERS ARE ELECTED FOR TERMS OF UP TO THREE YEARS, ARE SUBJECT TO TERM LIMITS AND REPRESENT A WIDE SPECTRUM OF COMMUNITY INTERESTS-INCLUDING SOCIAL SERVICE PROVIDERS, LOCAL BUSINESS LEADERS, FINANCIAL PROFESSIONALS, CONSUMER ADVOCATES AND EDUCATIONAL LEADERS. MOST COMMITTEES OF THE BOARD OF TRUSTEES INCLUDE ADDITIONAL COMMUNITY REPRESENTATIVES. BHS MAINTAINS A PATIENT AND FAMILY COUNCIL TO PROVIDE INPUT AND ADVICE ON A WIDE RANGE OF SERVICE TOPICS.THE MEDICAL STAFF OF BHS IS OPEN TO ALL PHYSICIANS WHO MEET CLINICAL AND PATIENT SERVICE CRITERIA, ALTHOUGH CERTAIN HOSPITAL-BASED SERVICES-RADIOLOGY, ANESTHESIA, EMERGENCY DEPARTMENT AND PATHOLOGY-ARE FUNCTIONALLY CLOSED BECAUSE OF THE WAY THOSE DEPARTMENTS ARE STRUCTURED.BMC REGULARLY EXPENDS PERSONNEL AND FINANCIAL RESOURCES IN SUPPORT OF COMMUNITY INITIATIVES THAT PROMOTE IMPROVEMENTS IN COMMUNITY HEALTH AND WELL-BEING AND FOR WHICH IT DOES NOT EXPECT REIMBURSEMENT. THE HOSPITAL UTILIZES SURPLUS FUNDS FOR CAPITAL IMPROVEMENTS AND TO MAINTAIN ACCESS TO PATIENT SERVICES AND EXPAND ACCESS POINTS OF CARE AND SERVICES THAT SUPPORT COMMUNITY BENEFIT PRIORITIES TO PATIENTS THROUGHOUT THE COMMUNITY. THE BERKSHIRE COUNTY COMMUNITY HAS LONG LABORED UNDER A CRITICAL PHYSICIAN SHORTAGE IN VARIOUS SPECIALTIES AND BHS HAS IN RECENT YEARS EXPENDED SIGNIFICANT PERSONNEL TIME AND FINANCIAL RESOURCES IN RECRUITING PHYSICIANS TO THE AREA AS DIRECT EMPLOYEES OF BHS OR ITS AFFILIATES. MOREOVER, BMC HAS, IN APPROPRIATE WAYS, PROVIDED SUBSTANTIAL ASSISTANCE TO COMMUNITY MEDICAL PRACTICES TO RECRUIT AND SUPPORT THE PRACTICE START-UP OF NEW PHYSICIANS IN NEEDED SPECIALTIES. THE HEALTH SYSTEM IS ALSO FACING CRITICAL SHORTAGES IN VARIOUS AREAS OF NURSING AND HEALTHCARE. AS DISCUSSED AT GREATER LENGTH IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), BMC CONTINUALLY GOES ABOVE AND BEYOND TO SUPPORT THE HEALTH OF THE COMMUNITY THROUGH EXTENSIVE COMMUNITY OUTREACH PROGRAMS AND SUPPORT, COMPREHENSIVE, COMMUNITY-BASED INITIATIVES TO ADDRESS SUCH DIVERSE HEALTHCARE CHALLENGES AS DIABETES, HYPERTENSION AND HEART FAILURE, SMOKING CESSATION, FALLS PREVENTION, AND CHRONIC PAIN MANAGEMENT/NARCOTICS USE AND DIVERSION, AND ACCESS TO CARE.EXAMPLES OF BMC PROMOTING THE HEALTH OF THE COMMUNITY IN FY21 INCLUDES BUT IS NOT LIMITED TO:DONATED FUNDS TO COMMUNITY EVENTS, LOCAL SPORTS TEAMS, ORGANIZATIONS, AND INITIATIVESHOSTED SEVERAL COMMUNITY EVENTS INCLUDING A SUPPORT GROUPS AND COMMUNITY EDUCATION, BMC INDEPENDENCE DAY RUN, BERKSHIRES 150, FOOD SERVICE DONATION TO HOMELESS SHELTERS MEDICAL STUDENTS PROVIDING HEALTH EDUCATION AT COMMUNITY EVENTSMEMBERS OF THE WELLNESS PROGRAM AND MANAGEMENT TEAM PROVIDING BLOOD PRESSURE SCREENINGS, HEALTH EDUCATION, ENVIRONMENTAL CLEAN UPS, AND OTHER COMMUNITY VOLUNTEERISMOFFERED COMMUNITY PARTNERS FREE ACCESS TO COMMUNITY HEALTH WORKER TRAINING PROGRAMPROVIDED JOURNEY TO HEALTH, A SERIES OF CLASSES ON HEALTH AND WELLBEING WITH PRESENTATIONS DELIVERED BY DOCTORS, NURSES, DIETITIANS, AND SOCIAL WORKERSSUPPORTED A WIDE VARIETY OF COMMUNITY ORGANIZATIONS AND INITIATIVES INCLUDING HEALTH RELATED ORGANIZATIONS SUCH AS THE BRIEN CENTER (MENTAL HEALTH AND ADDICTION TREATMENT), THE ELIZABETH FREEMAN CENTER (RAPE AND SEXUAL ASSAULT SUPPORT), HILLCREST EDUCATIONAL CENTERS (EDUCATION FOR YOUTH WITH DEVELOPMENTAL DISABILITIES), AND THE DARE PROGRAM (DRUG-RESISTANCE PROGRAM FOR KIDS)SUPPORTED SIGNIFICANT COMMUNITY EDUCATIONAL AND CULTURAL INSTITUTIONS IN OUR AREA INCLUDING BERKSHIRE COMMUNITY COLLEGE, BERKSHIRE THEATRE GROUP, MASSACHUSETTS COLLEGE OF LIBERAL ARTS, THE PITTSFIELD PARADE COMMITTEE, GIRLS INC., AND COMMUNITY ACCESS TO THE ARTSASSISTED COMMUNITY AGENCIES WITH NALOXONE AND EDUCATION