{ "schemaVersion": 3, "entityId": "220036", "canonicalName": "BMC Brighton / St. Elizabeth's Medical Center", "status": "corporate_chain", "statusLabel": "Major nonprofit health-system accountability warning", "summary": "BMC Brighton is now operated by nonprofit BMC Health System after the October 1, 2024 Steward transaction. Current CMS ownership text may still show the former proprietary classification. The accountability focus is post-acquisition stabilization, public support, staffing and wage disputes, and separation of Steward-era liabilities from BMC-era decisions.", "lastReviewed": "2026-07-12", "review": { "reviewer": "Official-first BMC deep research and public-accountability pass", "evidence_grade": "primary_government_audited_and_attributed_labor_sources", "confidence": "high", "source_count": 32, "ownership_source_count": 5, "identity_match_method": "Exact CMS CCN, EIN and legal-entity matching across CMS, IRS, audit and Massachusetts records.", "publication_decision": "Publish as a major nonprofit health-system accountability warning. Preserve the operating-loss/system-liquidity distinction, attribute union claims, and classify SHC as PE-backed contract exposure rather than BMC ownership." }, "firstGlance": { "taxOwnershipType": "Nonprofit", "operator": "BMC Health System", "directPeOwnership": "No documented direct PE ownership in reviewed sources", "peRelationship": "Confirmed PE-backed temporary-staffing vendor: Supplemental Health Care, owned equally by Vistria Fund IV and Apollo Impact Mission", "institutionalShareholderContext": "Not applicable to nonprofit parent control; private investment-fund holdings are assets, not hospital shareholders.", "populationServedEstimate": 0, "populationServedLabel": "Three-hospital safety-net system; BMC publishes approximately 3,000 nurses across the system.", "careLevel": "Acute-care community hospital", "currentCeo": "BMC Health System leadership; facility-specific current executive roster requires separate confirmation", "previousRelevantCeo": "Formerly operated by Steward Health Care before October 1, 2024", "confidence": "High for finance, control, contractors and public ratings; provisional for exact nurse-pay affordability because payroll and agency-hours files are not public.", "bottomLine": "BMC Brighton is not currently classified as PE-owned. It was acquired from Steward by nonprofit BMC Health System and is covered by a $250M supplemental-payment schedule over FY2025-FY2027. Labor complaints are credible attributed claims, but exact post-acquisition staffing and payroll files remain unavailable." }, "communityImpact": { "populationServedEstimate": 0, "populationServedLabel": "BMC reports a high public-payer safety-net mission; CHIA reports 77.9% public payer mix.", "estimateMethod": "CHIA HFY2024 hospital profile and BMC public system descriptions.", "catchmentDescription": "Boston, Brighton, Brockton and surrounding communities served by the three-hospital system and community health-center network.", "traumaCareLevel": "Adult Level 1 and Pediatric Level 1 trauma center at the main campus.", "publicFacingCaveat": "Safety-net payer mix explains operating pressure but does not by itself resolve wage affordability or staffing adequacy." }, "qualityAndLaborContext": { "immediateJeopardy2026SourceStatus": "No current CMS immediate-jeopardy finding was established in this pass.", "noCausationClaim": true, "note": "Main campus: CMS 3 stars, Leapfrog A, Magnet, 10.52 total nursing HPPD and 6.65 RN HPPD. Main-campus nurses received a large 2023 contract increase and were bargaining again in 2026. South/Brighton labor claims concern wages, benefits, retention and staffing; those claims are attributed and do not replace unit-level staffing data." }, "leadership": [ { "name": "Alastair Bell, MD, MBA", "role": "President and CEO, BMC Health System", "context": "FY2024-return compensation totaled approximately $1.949M, including a $459,250 incentive component disclosed in Schedule J.", "sourceId": "audit_fy24", "compensation": "$1,949,276 reportable plus other compensation in the FY2024 return context", "compensationSourceId": "form990_bmc" }, { "name": "Anthony Hollenberg, MD", "role": "President, Boston Medical Center", "context": "Current hospital president; the filing amount may not represent a full year in the current title.", "sourceId": "form990_bmc", "compensation": "$964,350 reportable plus other compensation in the FY2024 return context", "compensationSourceId": "form990_bmc" }, { "name": "Nancy Gaden, DNP, RN, NEA-BC", "role": "Chief Nursing Officer / senior clinical operations leadership", "context": "Named nursing executive in the compensation filing.", "sourceId": "form990_bmc", "compensation": "$842,263 reportable plus other compensation in the FY2024 return context", "compensationSourceId": "form990_bmc" } ], "identifiers": { "ccn": "220036", "npi": "1720814072", "historicalCcns": [], "aliases": [ { "alias": "BMC Brighton", "alias_type": "current_system_name", "source_id": "bmc_acquisition" }, { "alias": "St. Elizabeth's Medical Center", "alias_type": "former_steward_name", "source_id": "cms_chow" } ] }, "ownershipHistory": [ { "relationship_id": "bmc-system-nonprofit-control", "relationship_type": "operates", "effective_date": "", "end_date": "", "status": "confirmed", "source_ids": "audit_fy24|form990_bmc|form990_system", "plain_english_summary": "BMC Health System is the nonprofit parent/control layer for the hospital, health plan and related organizations." }, { "relationship_id": "bmc-shc-staffing-contract", "relationship_type": "temporary_staffing_contract", "effective_date": "2021", "end_date": "", "status": "confirmed", "source_ids": "form990_bmc|shc_ownership|shc_recap", "plain_english_summary": "BMC paid SHC Services/Supplemental Health Care $69.6M in the FY2024 contractor table; Vistria Fund IV and Apollo Impact Mission are equal owners of the vendor. This is contract exposure, not BMC ownership." }, { "relationship_id": "bmc-acquired-south-brighton", "relationship_type": "acquired_and_operates", "effective_date": "2024-10-01", "end_date": "", "status": "confirmed", "source_ids": "cms_chow|bmc_acquisition|mass_steward_transfer|mtf_steward", "plain_english_summary": "BMC Health System acquired Good Samaritan/BMC South and St. Elizabeth’s/BMC Brighton after Steward’s bankruptcy." } ], "acquisitionEvents": [ { "date": "2024-10-01", "title": "BMC Brighton enters BMC Health System", "detail": "CMS CHOW and BMC/State sources document the transfer from Steward. The MTF schedule assigns $250M in supplemental payments over FY2025-FY2027.", "sourceIds": [ "cms_chow", "bmc_acquisition", "mass_steward_transfer", "mtf_steward" ] } ], "financialAndUtilizationSeries": [ { "metric_id": "bmc-scheduled_steward_transition_support-2025-2027", "metric_name": "scheduled_steward_transition_support", "period_start": "2025-2027", "period_end": "2025-2027", "value": "250000000", "unit": "USD", "source_id": "mtf_steward", "methodology_note": "$250M supplemental-payment schedule for St. Elizabeth's Medical Center." }, { "metric_id": "bmc-cms_overall_rating-2026", "metric_name": "cms_overall_rating", "period_start": "2026", "period_end": "2026", "value": "3", "unit": "stars", "source_id": "cms_general", "methodology_note": "Current reviewed CMS snapshot." } ], "ownershipChain": { "model": "Sponsor, operator, CMS legal-owner/control records, and facility are shown as separate evidence layers.", "confidence": "high", "nodes": [ { "id": "facility:220036", "label": "BOSTON MEDICAL CENTER-BRIGHTON", "kind": "hospital", "evidence": "public facility record" }, { "id": "organization:bmc-community-hospital-corporation-ii", "label": "BMC COMMUNITY HOSPITAL CORPORATION II", "kind": "portfolio_company_or_operator", "evidence": "research tracker or primary organizational source" } ], "edges": [ { "id": "organization:bmc-community-hospital-corporation-ii->facility:220036", "from": "organization:bmc-community-hospital-corporation-ii", "to": "facility:220036", "relationship": "reported ownership or operating chain", "confidence": "high", "sourceIds": [ "audit_fy24", "form990_bmc", "form990_system", "form990_bmc", "shc_ownership", "shc_recap", "cms_chow", "bmc_acquisition", "mass_steward_transfer", "mtf_steward" ], "note": "The platform attribution comes from the research tracker and is displayed separately from CMS legal-owner rows." } ], "caveats": [ "CMS owner rows establish enrolled legal ownership or control roles; they do not always name the ultimate financial sponsor." ] }, "ownershipConnections": [ { "entityName": "BMC Health System", "entityKind": "501(c)(3) nonprofit parent", "relationship": "parent/control and operating system", "classification": "Major nonprofit system", "evidenceSourceIds": [ "audit_fy24", "form990_system" ], "note": "Controls the hospital, health plan and related entities; this is not shareholder ownership." }, { "entityName": "WellSense Health Plan", "entityKind": "nonprofit managed-care organization", "relationship": "related health-plan entity", "classification": "Insurance/capitation business", "evidenceSourceIds": [ "audit_fy24", "form990_plan" ], "note": "Explains much of the system’s scale and capitation revenue; regulated insurance resources are not automatically fungible for hospital payroll." }, { "entityName": "Supplemental Health Care / SHC Services", "entityKind": "temporary-staffing company", "relationship": "largest disclosed temporary-staffing contractor", "classification": "PE-backed contract exposure", "evidenceSourceIds": [ "form990_bmc", "shc_ownership", "shc_recap" ], "note": "$69.6M FY2024 payment; vendor owned equally by Vistria Fund IV and Apollo Impact Mission." }, { "entityName": "Southern Middlesex Industries", "entityKind": "construction vendor", "relationship": "disclosed $10.8M contractor", "classification": "Historical vendor-integrity flag", "evidenceSourceIds": [ "form990_bmc", "southern_case", "southern_current" ], "note": "Federal records document historical labor-fraud conduct tied to leadership; no evidence reviewed shows BMC participated." }, { "entityName": "Commonwealth of Massachusetts", "entityKind": "public funder and regulator", "relationship": "former-Steward transition support", "classification": "Public funding", "evidenceSourceIds": [ "mtf_steward", "mass_steward_transfer" ], "note": "$387M BMC-specific supplemental schedule across South and Brighton over FY2025-FY2027." } ], "importantLinks": [ { "label": "Consolidated finances, investments, debt, acquisitions and audit controls", "url": "https://www.bmc.org/sites/default/files/Research/uniform-guidance/BMCHS-Independent-Auditors-Reports-FY24.pdf", "sourceId": "audit_fy24", "note": "FY2024 operating loss $81.3M; investment income $220.4M; after-tax excess $137.7M; $1.63B available within one year Limitation: Consolidated system; some assets are restricted or regulated" }, { "label": "Hospital revenue, expenses, contractors, executive compensation, community benefit and related-party disclosure", "url": "https://projects.propublica.org/nonprofits/organizations/43314093", "sourceId": "form990_bmc", "note": "BMC Corporation FY2024 deficit $41.0M; top-five contractor table; CEO compensation and Schedule H Limitation: Contractor and compensation reporting periods can lag the fiscal period" }, { "label": "Parent-system governance and related organizations", "url": "https://projects.propublica.org/nonprofits/organizations/463556853", "sourceId": "form990_system", "note": "Identifies BMC Health System nonprofit parent and related-entity structure Limitation: Return-level detail does not disclose every intercompany transfer" }, { "label": "WellSense health-plan finances and related-system scale", "url": "https://projects.propublica.org/nonprofits/organizations/43373331", "sourceId": "form990_plan", "note": "Plan revenue and assets help explain why consolidated system results differ from hospital operations Limitation: Insurance reserves and regulatory requirements limit fungibility" }, { "label": "Hospital-specific financial, utilization, payer mix, staffed beds and system margin cross-check", "url": "https://www.chiamass.gov/assets/docs/r/hospital-profiles/2024/bmc.pdf", "sourceId": "chia_profile", "note": "539 staffed beds; 9,861 FTEs; 77.9% public payer; system surplus $137.7M; system operating margin -1.1% Limitation: Hospital and system measures appear together and must not be conflated" }, { "label": "Reconcile BMC-specific former-Steward supplemental payments with statewide package headlines", "url": "https://masstaxpayers.org/sites/default/files/publications/2025-01/MTF%20Steward%20Financial%20Analysis.pdf", "sourceId": "mtf_steward", "note": "Good Samaritan $137M plus St. Elizabeth's $250M equals $387M over FY2025-FY2027 Limitation: Analysis relies on state payment plans available in January 2025" }, { "label": "Facility identity, current CMS ownership label and overall quality rating", "url": "https://data.cms.gov/provider-data/dataset/xubh-q36u", "sourceId": "cms_general", "note": "BMC main 3 stars; Brighton 3 stars; South 2 stars in reviewed snapshot Limitation: CMS ownership labels for acquired hospitals can lag the October 2024 nonprofit takeover" }, { "label": "Confirm the October 1, 2024 change of ownership at Brighton and South", "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-change-of-ownership", "sourceId": "cms_chow", "note": "CMS CHOW records identify BMC nonprofit acquisition vehicles and former Steward entities Limitation: CHOW records establish transaction identity, not every purchase term" }, { "label": "Check current enrolled owners and PE/investment-firm flags", "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners", "sourceId": "cms_owners", "note": "No reviewed record supports direct PE ownership of BMC main campus Limitation: Officer/control rows require interpretation and may update after transactions" }, { "label": "Safety grade, Magnet status, beds, volumes and nursing-hours benchmarks", "url": "https://ratings.leapfroggroup.org/facility/details/22-0031/boston-medical-center-boston-ma", "sourceId": "leapfrog", "note": "Fall 2025 A grade; 10.52 total nursing HPPD and 6.65 RN HPPD reported Limitation: Survey and rating periods differ from CMS; HPPD is not a nurse headcount" }, { "label": "Main-campus nurse workforce lower bound", "url": "https://www.bmc.org/medical-professionals/nursing/education", "sourceId": "bmc_nursing", "note": "BMC says the nursing department includes more than 1,700 RNs Limitation: Rounded employer-published count" }, { "label": "System-wide planning denominator", "url": "https://healthcity.bmc.org/5-bmc-health-system-nurses-share-their-advice-to-aspiring-and-fellow-nurses/", "sourceId": "bmc_system_nurses", "note": "BMC says the three-hospital system employs approximately 3,000 nurses Limitation: Rounded employer-published estimate" }, { "label": "Establish the prior main-campus wage contract and bargaining-unit scale", "url": "https://www.1199seiu.org/massachusetts/1199seiu-nurses-ratify-new-contract-boston-medical-center", "sourceId": "seiu_main_2023", "note": "Nearly 2,000 nurses ratified a contract with 20% RN increases and a top experienced rate of $93.65 per hour Limitation: Union account; the contract expired or approached renewal in 2026" }, { "label": "Identify active 2026 system bargaining and workforce scope", "url": "https://www.1199seiu.org/massachusetts/unions-across-boston-medical-center-system-call-fair-contract-now-4000-members", "sourceId": "seiu_system_2026", "note": "Unions described more than 4,000 workers in bargaining across the BMC system Limitation: Attributed labor statement" }, { "label": "Track contract result for non-MNA workers at Brighton and South", "url": "https://www.1199seiu.org/massachusetts/1400-healthcare-workers-bmc-brighton-and-south-ratify-new-union-contract-averting-strike", "sourceId": "seiu_acquired_contract", "note": "About 1,400 workers ratified a three-year agreement with wage and benefit protections Limitation: Does not resolve the separate MNA nurse bargaining unit" }, { "label": "Document current BMC South nurse and health-professional complaints", "url": "https://www.massnurses.org/2026/04/20/bmc-south-rns-and-healthcare-professionals-submit-official-notice-of-three-day-strike-from-april-30-may-3-as-talks-for-a-new-contract-stall-over-staffing-wages-and-dramatic-cuts-to-hea/", "sourceId": "mna_south_strike", "note": "475 represented workers alleged staffing, wage and health-benefit problems; BMC said its offer was market competitive Limitation: Attributed bargaining claims, not an independent staffing audit" }, { "label": "Check the latest identified BMC South bargaining status", "url": "https://www.massnurses.org/2026/06/04/bmc-south-rns-and-health-professionals-to-picket-on-june-8th-in-fight-for-respect-and-safer-care-as-bmc-seeks-to-bully-them-into-accepting-an-unfair-contract-settlement/", "sourceId": "mna_south_june", "note": "June 2026 picket notice said talks remained unresolved and staffing concerns continued Limitation: Status may change after publication" }, { "label": "Confirm acquisition effective date and current system names", "url": "https://www.bmc.org/news/boston-medical-center-health-system-welcomes-good-samaritan-medical-center-and-st-elizabeths", "sourceId": "bmc_acquisition", "note": "Good Samaritan and St. Elizabeth's joined BMC Health System on October 1, 2024 Limitation: Employer announcement" }, { "label": "Confirm signed transfer agreements and public purpose", "url": "https://www.mass.gov/news/governor-healey-announces-agreements-now-signed-to-save-four-steward-hospitals", "sourceId": "mass_steward_transfer", "note": "State announced signed hospital transfer agreements and BMC's role in preserving the two facilities Limitation: Summary release; does not itemize all later payments" }, { "label": "Main-campus capital project and community-health obligation", "url": "https://www.mass.gov/doc/staff-report-pdf-boston-medical-center-hospitalclinic-substantial-capital-expenditure/download", "sourceId": "don_expansion", "note": "Approved $121.24M expansion with 70 inpatient beds, five operating rooms and $6.06M CHI contribution Limitation: Project-era budget" }, { "label": "Regulatory review of former-Steward acquisitions", "url": "https://masshpc.gov/sites/default/files/2024-09/20240916_BMC-Steward.pdf", "sourceId": "hpc_steward", "note": "HPC materials identify BMC's proposed acquisition of St. Elizabeth's and Good Samaritan Limitation: Regulatory presentation predates full integration results" }, { "label": "Current post-acquisition financial pressure and BMC-specific state support", "url": "https://www.bostonglobe.com/2026/06/01/business/boston-medical-center-losses/", "sourceId": "globe_fy26", "note": "First-half FY2026 operating loss $41.7M; approximately $387M state support reported for acquisition and upgrades Limitation: Secondary source and possible paywall" }, { "label": "Historical federal grants and contract obligations", "url": "https://www.usaspending.gov/recipient", "sourceId": "usaspending", "note": "Exact-name API search returned about $782.4M grants and $12.5M contracts from FY2008 through July 11 2026 Limitation: Obligations are not cash receipts; name and UEI variants may omit awards" }, { "label": "Historical Medicare compliance check", "url": "https://oig.hhs.gov/fraud/enforcement/boston-medical-center-settles-false-and-fraudulent-medicare-claims-case/", "sourceId": "hhs_oig", "note": "BMC paid $313,246 in 2017 to settle alleged false or fraudulent Medicare claims Limitation: Historical settlement does not prove a current pattern" }, { "label": "Check labor-law case filings", "url": "https://www.nlrb.gov/case/01-CA-345428", "sourceId": "nlrb_case", "note": "Case 01-CA-345428 records a refusal-to-furnish-information charge Limitation: A charge filing is not a finding of violation; disposition requires confirmation" }, { "label": "Trace the private-capital owner of BMC's largest disclosed temporary-staffing vendor", "url": "https://vistria.com/the-vistria-group-announces-sale-of-and-new-partnership-with-supplemental-health-care/", "sourceId": "shc_ownership", "note": "Vistria Fund IV and Apollo Impact Mission became equal owners of Supplemental Health Care Limitation: Owner-issued announcement" }, { "label": "Check financing and distributions at the staffing vendor", "url": "https://vistria.com/the-vistria-group-announces-dividend-recapitalization-of-supplemental-health-care/", "sourceId": "shc_recap", "note": "A $100M incremental-debt dividend recap returned about 30% of Vistria's invested capital Limitation: Not a BMC transaction and no evidence BMC approved it" }, { "label": "Historical integrity check for a disclosed construction vendor", "url": "https://www.oig.dol.gov/public/Press%20Releases/Massachusetts%20Asbestos%20Abatement%20Company%20And%20Owner%20Sentenced%20For%20Defrauding%20Union%20Benefit%20Funds.pdf", "sourceId": "southern_case", "note": "Federal sentencing release describes a union-benefit and overtime fraud scheme tied to Southern Middlesex leadership Limitation: Historical vendor conduct; no evidence BMC participated" }, { "label": "Match the current vendor identity, address and principals", "url": "https://www.smienvironmental.com/aboutus", "sourceId": "southern_current", "note": "Current company page matches the name, address and leadership used for vendor-integrity reconciliation Limitation: Self-published company information" }, { "label": "Identify publicly acknowledged corporate relationships and sponsorships", "url": "https://development.bmc.org/get-involved/corporate-partnerships/thank-you-to-our-corporate-partners/", "sourceId": "bmc_corporate_partners", "note": "Lists corporate partners supporting BMC programs Limitation: Sponsorship does not prove a procurement contract" }, { "label": "Identify BMC Brockton Behavioral Health Center project team and cost", "url": "https://www.enr.com/articles/57580-best-project-health-care-boston-medical-center-brockton-behavioral-health-center", "sourceId": "enr_brockton", "note": "Describes the approximately $41M project and Southern Middlesex role Limitation: Trade publication; not a complete contract" }, { "label": "Identify an electrical trade contractor on BMC capital work", "url": "https://www.mcdonaldcorp.com/news/mcdonald-electrical-enhances-safety-and-infrastructure-in-boston-medical-centers-menino-lobby-redesign/", "sourceId": "mcdonald_project", "note": "Vendor identifies its Menino lobby infrastructure and safety work Limitation: Vendor-authored project description; contract value not disclosed" } ], "systemConnections": [ { "systemName": "BMC Health System", "relationship": "nonprofit parent and operating system", "evidenceSourceIds": [ "audit_fy24", "cms_chow", "bmc_acquisition" ], "facilities": [ { "name": "Boston Medical Center", "role": "Academic medical center / main campus", "city": "Boston", "state": "MA", "recordId": "220031" }, { "name": "Boston Medical Center-Brighton", "role": "Acquired former St. Elizabeth’s", "city": "Brighton", "state": "MA", "recordId": "220036" }, { "name": "Boston Medical Center-South", "role": "Acquired former Good Samaritan", "city": "Brockton", "state": "MA", "recordId": "220111" } ] } ], "directConnections": [ "BMC Health System -> Boston Medical Center: nonprofit parent/control relationship.", "BMC Health System -> BMC South and BMC Brighton: October 1, 2024 acquisition and operating relationship.", "Vistria Fund IV + Apollo Impact Mission -> Supplemental Health Care -> BMC: vendor ownership and staffing-contract path.", "Commonwealth of Massachusetts -> South/Brighton: scheduled supplemental support for post-Steward stabilization." ], "actions": [ "Publish all 251 contractors over $100,000, not only the top five.", "Publish SHC rate cards, traveler hours, disciplines, campus allocation and conversion fees.", "Publish unit-level staffing, vacancy, turnover, overtime, missed-break and acuity data.", "Publish private investment-fund names, managers, fees and health-care portfolio exposure.", "Publish the executive incentive scorecard and FY2025 audit remediation.", "Reconcile the $387M South/Brighton support schedule to actual annual expenditures." ], "contradictions": [ { "topic": "broke_or_no_money", "claim_a": "Hospital and post-acquisition operations show real recurring losses.", "claim_b": "The consolidated system reported a positive after-tax excess, substantial investments and $1.63B available within one year.", "resolution_status": "Both can be true; affordability claims must identify the entity, restriction, period and recurring funding source." }, { "topic": "staffing_and_pay", "claim_a": "Unions report staffing, retention, wage and benefit problems, especially at South and Brighton.", "claim_b": "BMC says offers are market competitive; the main campus previously negotiated a large 2023 RN increase.", "resolution_status": "Attributed dispute; actual wage-grid, vacancy and unit-staffing files are needed for adjudication." } ], "limitations": [ "Only the five largest contractors are named publicly even though 251 received more than $100,000.", "Private investment-fund names and managers are not disclosed in the audited statements.", "Exact nurse wage distribution, marginal benefit load, agency hours/rates and campus allocation are not public.", "CMS ownership labels can lag the October 2024 nonprofit acquisition of South and Brighton.", "Union statements are attributed claims, not independent staffing audits.", "The nurse-pay options are planning models, not forecasts or collective-bargaining terms.", "Pre-October 2024 cost-report history reflects Steward-era operations and should not be treated as post-acquisition BMC performance.", "Facility-specific post-acquisition audited statements are not publicly available in the reviewed sources." ], "unavailableFields": [ "all_251_contractors_over_100k", "private_fund_names_managers_and_fees", "nurse_wage_distribution_by_campus_and_step", "agency_bill_rates_hours_disciplines_and_campus_allocation", "unit_level_vacancy_turnover_overtime_acuity_and_assignments", "executive_incentive_scorecard", "fy2025_audit_remediation_status" ], "accountabilityAnalysis": { "sourceInventory": { "sourcePageCount": 32, "websiteHostnameCount": 21, "registerUrl": "/data/dossiers/220031.json", "flowchartImageUrl": "/diagrams/boston-medical-center/research-and-pay-flow-preview.png", "flowchartDownloadUrl": "/diagrams/boston-medical-center/research-and-pay-flow.excalidraw", "flowchartShareUrl": "https://excalidraw.com/#json=0IdUkYt-WsqSgz52LHSUM,6T-pT4QqCd7iZV0gBJjtsw", "categories": [ { "title": "CMS and Census", "purpose": "Facility identity, coordinates, ownership labels, change-of-ownership events and quality ratings.", "result": "Locked CCNs 220031, 220036 and 220111 and separated stale CMS labels from current nonprofit control." }, { "title": "Audits, IRS and CHIA", "purpose": "Operating results, total margin, investments, liquidity, contractors, executive pay and community benefit.", "result": "Established the operating-loss versus total-surplus distinction and the $69.6M SHC staffing contract." }, { "title": "Massachusetts records", "purpose": "Capital projects, acquisition review and former-Steward public support.", "result": "Reconciled BMC-specific supplemental payments to $387M: $137M South plus $250M Brighton." }, { "title": "Quality and workforce", "purpose": "CMS/Leapfrog ratings, staffed beds, nurse counts and nursing-hours benchmarks.", "result": "Main campus is CMS 3 stars and Leapfrog A; public data still lacks unit-level staffing ratios." }, { "title": "Labor sources", "purpose": "Contract outcomes, bargaining scope and attributed staffing/wage complaints.", "result": "Separated the main-campus 2023 raise history from current South/Brighton disputes and 2026 bargaining." }, { "title": "Vendors, private capital and enforcement", "purpose": "Trace contractor ownership and historical integrity issues.", "result": "Confirmed PE-backed SHC contract exposure without relabeling BMC as PE-owned." } ] }, "nursePayPlan": { "decision": "Raise permanent nurse pay from recurring operating savings, not asset sales, restricted funds, debt, benefit cuts or clinical service reductions.", "preferredOption": "Targeted campus parity and retention: use verified agency-spend conversion to fund a modeled 6% recurring raise for up to about 1,700 lower-paid or hard-to-fill nurse FTEs under the central assumptions.", "assumptions": [ "Approximately 3,000 system nurses and more than 1,700 main-campus RNs are employer-published rounded counts.", "Central planning assumption: $120,000 average base pay and 25% marginal payroll/benefit load; $100,000 and $140,000 sensitivities are in the notebook.", "SHC temporary-staffing spend is $69,578,940 from the FY2024 Form 990 contractor table.", "Twenty-five percent of gross agency savings is reserved for recruiting, onboarding, temporary coverage and quality protection.", "The model is provisional because actual wage grids, agency bill rates, hours and campus allocation are not public." ], "options": [ { "rank": 1, "title": "Targeted campus parity and retention", "raiseDesign": "6% recurring base-rate increase for up to approximately 1,700 lower-paid or hard-to-fill nurse FTEs", "annualLoadedCost": "$15.3M", "recurringFunding": "$15.7M", "fundingMechanism": "Reduce verified SHC spend 30%; reserve 25% of gross savings for conversion and quality.", "tradeoff": "Best targets documented pressure, but final cohort requires actual campus wage and vacancy files." }, { "rank": 2, "title": "Uniform system-wide adjustment", "raiseDesign": "3% recurring base-rate increase for approximately 3,000 system nurses", "annualLoadedCost": "$13.5M", "recurringFunding": "$15.7M", "fundingMechanism": "Use the same 30% verified SHC-spend reduction and 25% reserve.", "tradeoff": "Simple and equitable to administer, but less targeted across different campus wage histories." }, { "rank": 3, "title": "Staged gainshare", "raiseDesign": "2% guaranteed now plus 2% after jointly audited agency-hour and vacancy savings", "annualLoadedCost": "$18.0M at the full 4%", "recurringFunding": "$18.3M", "fundingMechanism": "Reduce verified SHC spend 35%; reserve 25% of gross savings for conversion and quality.", "tradeoff": "Protects liquidity, but the second installment needs an automatic transparent trigger." } ], "guardrails": [ "No staffed-bed, permanent-nurse-FTE or service-line cuts may fund the raise.", "Agency hours may fall only as permanent staffed hours rise or remain sufficient for acuity.", "Main-campus RN HPPD should not fall below 6.65 and total nursing HPPD should not fall below 10.52 unless a newer audited baseline replaces them.", "Report vacancies, turnover, overtime, missed breaks, falls, medication errors, CLABSI, CAUTI, readmissions and complaints monthly by unit and campus.", "Protect debt covenants, restricted funds and insurance reserves; do not borrow for recurring payroll." ], "requiredDisclosures": [ "Nurse roster and FTE distribution by campus, unit and wage step", "Current base-wage grids, differentials and marginal benefit load", "SHC and other agency master agreements, bill rates, hours, disciplines and conversion fees", "Vacancy, turnover, overtime, missed-break and acuity-adjusted staffing data", "A monthly bridge showing agency savings converted into permanent wages" ], "notebookPath": "research/inbox/2026-07-12/boston-medical-center/bmc-nurse-pay-scenarios.ipynb" } }, "sources": [ { "source_id": "audit_fy24", "title": "Consolidated finances, investments, debt, acquisitions and audit controls", "publisher": "BMC Health System/KPMG", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.bmc.org/sites/default/files/Research/uniform-guidance/BMCHS-Independent-Auditors-Reports-FY24.pdf", "reliability_tier": "audited_filing", "research_note": "FY2024 operating loss $81.3M; investment income $220.4M; after-tax excess $137.7M; $1.63B available within one year Limitation: Consolidated system; some assets are restricted or regulated" }, { "source_id": "form990_bmc", "title": "Hospital revenue, expenses, contractors, executive compensation, community benefit and related-party disclosure", "publisher": "IRS via ProPublica", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://projects.propublica.org/nonprofits/organizations/43314093", "reliability_tier": "tax_filing", "research_note": "BMC Corporation FY2024 deficit $41.0M; top-five contractor table; CEO compensation and Schedule H Limitation: Contractor and compensation reporting periods can lag the fiscal period" }, { "source_id": "form990_system", "title": "Parent-system governance and related organizations", "publisher": "IRS via ProPublica", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://projects.propublica.org/nonprofits/organizations/463556853", "reliability_tier": "tax_filing", "research_note": "Identifies BMC Health System nonprofit parent and related-entity structure Limitation: Return-level detail does not disclose every intercompany transfer" }, { "source_id": "form990_plan", "title": "WellSense health-plan finances and related-system scale", "publisher": "IRS via ProPublica", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://projects.propublica.org/nonprofits/organizations/43373331", "reliability_tier": "tax_filing", "research_note": "Plan revenue and assets help explain why consolidated system results differ from hospital operations Limitation: Insurance reserves and regulatory requirements limit fungibility" }, { "source_id": "chia_profile", "title": "Hospital-specific financial, utilization, payer mix, staffed beds and system margin cross-check", "publisher": "Center for Health Information and Analysis", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.chiamass.gov/assets/docs/r/hospital-profiles/2024/bmc.pdf", "reliability_tier": "government_profile", "research_note": "539 staffed beds; 9,861 FTEs; 77.9% public payer; system surplus $137.7M; system operating margin -1.1% Limitation: Hospital and system measures appear together and must not be conflated" }, { "source_id": "mtf_steward", "title": "Reconcile BMC-specific former-Steward supplemental payments with statewide package headlines", "publisher": "Massachusetts Taxpayers Foundation", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://masstaxpayers.org/sites/default/files/publications/2025-01/MTF%20Steward%20Financial%20Analysis.pdf", "reliability_tier": "policy_analysis", "research_note": "Good Samaritan $137M plus St. Elizabeth's $250M equals $387M over FY2025-FY2027 Limitation: Analysis relies on state payment plans available in January 2025" }, { "source_id": "cms_general", "title": "Facility identity, current CMS ownership label and overall quality rating", "publisher": "Centers for Medicare and Medicaid Services", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://data.cms.gov/provider-data/dataset/xubh-q36u", "reliability_tier": "government_data", "research_note": "BMC main 3 stars; Brighton 3 stars; South 2 stars in reviewed snapshot Limitation: CMS ownership labels for acquired hospitals can lag the October 2024 nonprofit takeover" }, { "source_id": "cms_chow", "title": "Confirm the October 1, 2024 change of ownership at Brighton and South", "publisher": "Centers for Medicare and Medicaid Services", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-change-of-ownership", "reliability_tier": "government_data", "research_note": "CMS CHOW records identify BMC nonprofit acquisition vehicles and former Steward entities Limitation: CHOW records establish transaction identity, not every purchase term" }, { "source_id": "cms_owners", "title": "Check current enrolled owners and PE/investment-firm flags", "publisher": "Centers for Medicare and Medicaid Services", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-all-owners", "reliability_tier": "government_data", "research_note": "No reviewed record supports direct PE ownership of BMC main campus Limitation: Officer/control rows require interpretation and may update after transactions" }, { "source_id": "leapfrog", "title": "Safety grade, Magnet status, beds, volumes and nursing-hours benchmarks", "publisher": "The Leapfrog Group", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://ratings.leapfroggroup.org/facility/details/22-0031/boston-medical-center-boston-ma", "reliability_tier": "quality_rating", "research_note": "Fall 2025 A grade; 10.52 total nursing HPPD and 6.65 RN HPPD reported Limitation: Survey and rating periods differ from CMS; HPPD is not a nurse headcount" }, { "source_id": "bmc_nursing", "title": "Main-campus nurse workforce lower bound", "publisher": "Boston Medical Center", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.bmc.org/medical-professionals/nursing/education", "reliability_tier": "employer_page", "research_note": "BMC says the nursing department includes more than 1,700 RNs Limitation: Rounded employer-published count" }, { "source_id": "bmc_system_nurses", "title": "System-wide planning denominator", "publisher": "BMC HealthCity", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://healthcity.bmc.org/5-bmc-health-system-nurses-share-their-advice-to-aspiring-and-fellow-nurses/", "reliability_tier": "employer_page", "research_note": "BMC says the three-hospital system employs approximately 3,000 nurses Limitation: Rounded employer-published estimate" }, { "source_id": "seiu_main_2023", "title": "Establish the prior main-campus wage contract and bargaining-unit scale", "publisher": "1199SEIU", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.1199seiu.org/massachusetts/1199seiu-nurses-ratify-new-contract-boston-medical-center", "reliability_tier": "union_statement", "research_note": "Nearly 2,000 nurses ratified a contract with 20% RN increases and a top experienced rate of $93.65 per hour Limitation: Union account; the contract expired or approached renewal in 2026" }, { "source_id": "seiu_system_2026", "title": "Identify active 2026 system bargaining and workforce scope", "publisher": "1199SEIU", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.1199seiu.org/massachusetts/unions-across-boston-medical-center-system-call-fair-contract-now-4000-members", "reliability_tier": "union_statement", "research_note": "Unions described more than 4,000 workers in bargaining across the BMC system Limitation: Attributed labor statement" }, { "source_id": "seiu_acquired_contract", "title": "Track contract result for non-MNA workers at Brighton and South", "publisher": "1199SEIU", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.1199seiu.org/massachusetts/1400-healthcare-workers-bmc-brighton-and-south-ratify-new-union-contract-averting-strike", "reliability_tier": "union_statement", "research_note": "About 1,400 workers ratified a three-year agreement with wage and benefit protections Limitation: Does not resolve the separate MNA nurse bargaining unit" }, { "source_id": "mna_south_strike", "title": "Document current BMC South nurse and health-professional complaints", "publisher": "Massachusetts Nurses Association", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.massnurses.org/2026/04/20/bmc-south-rns-and-healthcare-professionals-submit-official-notice-of-three-day-strike-from-april-30-may-3-as-talks-for-a-new-contract-stall-over-staffing-wages-and-dramatic-cuts-to-hea/", "reliability_tier": "union_statement", "research_note": "475 represented workers alleged staffing, wage and health-benefit problems; BMC said its offer was market competitive Limitation: Attributed bargaining claims, not an independent staffing audit" }, { "source_id": "mna_south_june", "title": "Check the latest identified BMC South bargaining status", "publisher": "Massachusetts Nurses Association", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.massnurses.org/2026/06/04/bmc-south-rns-and-health-professionals-to-picket-on-june-8th-in-fight-for-respect-and-safer-care-as-bmc-seeks-to-bully-them-into-accepting-an-unfair-contract-settlement/", "reliability_tier": "union_statement", "research_note": "June 2026 picket notice said talks remained unresolved and staffing concerns continued Limitation: Status may change after publication" }, { "source_id": "bmc_acquisition", "title": "Confirm acquisition effective date and current system names", "publisher": "BMC Health System", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.bmc.org/news/boston-medical-center-health-system-welcomes-good-samaritan-medical-center-and-st-elizabeths", "reliability_tier": "employer_release", "research_note": "Good Samaritan and St. Elizabeth's joined BMC Health System on October 1, 2024 Limitation: Employer announcement" }, { "source_id": "mass_steward_transfer", "title": "Confirm signed transfer agreements and public purpose", "publisher": "Commonwealth of Massachusetts", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.mass.gov/news/governor-healey-announces-agreements-now-signed-to-save-four-steward-hospitals", "reliability_tier": "government_release", "research_note": "State announced signed hospital transfer agreements and BMC's role in preserving the two facilities Limitation: Summary release; does not itemize all later payments" }, { "source_id": "don_expansion", "title": "Main-campus capital project and community-health obligation", "publisher": "Massachusetts Department of Public Health", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.mass.gov/doc/staff-report-pdf-boston-medical-center-hospitalclinic-substantial-capital-expenditure/download", "reliability_tier": "government_filing", "research_note": "Approved $121.24M expansion with 70 inpatient beds, five operating rooms and $6.06M CHI contribution Limitation: Project-era budget" }, { "source_id": "hpc_steward", "title": "Regulatory review of former-Steward acquisitions", "publisher": "Massachusetts Health Policy Commission", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://masshpc.gov/sites/default/files/2024-09/20240916_BMC-Steward.pdf", "reliability_tier": "government_filing", "research_note": "HPC materials identify BMC's proposed acquisition of St. Elizabeth's and Good Samaritan Limitation: Regulatory presentation predates full integration results" }, { "source_id": "globe_fy26", "title": "Current post-acquisition financial pressure and BMC-specific state support", "publisher": "Boston Globe", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.bostonglobe.com/2026/06/01/business/boston-medical-center-losses/", "reliability_tier": "reporting", "research_note": "First-half FY2026 operating loss $41.7M; approximately $387M state support reported for acquisition and upgrades Limitation: Secondary source and possible paywall" }, { "source_id": "usaspending", "title": "Historical federal grants and contract obligations", "publisher": "USAspending.gov", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.usaspending.gov/recipient", "reliability_tier": "government_data", "research_note": "Exact-name API search returned about $782.4M grants and $12.5M contracts from FY2008 through July 11 2026 Limitation: Obligations are not cash receipts; name and UEI variants may omit awards" }, { "source_id": "hhs_oig", "title": "Historical Medicare compliance check", "publisher": "HHS Office of Inspector General", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://oig.hhs.gov/fraud/enforcement/boston-medical-center-settles-false-and-fraudulent-medicare-claims-case/", "reliability_tier": "federal_enforcement", "research_note": "BMC paid $313,246 in 2017 to settle alleged false or fraudulent Medicare claims Limitation: Historical settlement does not prove a current pattern" }, { "source_id": "nlrb_case", "title": "Check labor-law case filings", "publisher": "National Labor Relations Board", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.nlrb.gov/case/01-CA-345428", "reliability_tier": "federal_docket", "research_note": "Case 01-CA-345428 records a refusal-to-furnish-information charge Limitation: A charge filing is not a finding of violation; disposition requires confirmation" }, { "source_id": "shc_ownership", "title": "Trace the private-capital owner of BMC's largest disclosed temporary-staffing vendor", "publisher": "Vistria Group", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://vistria.com/the-vistria-group-announces-sale-of-and-new-partnership-with-supplemental-health-care/", "reliability_tier": "owner_release", "research_note": "Vistria Fund IV and Apollo Impact Mission became equal owners of Supplemental Health Care Limitation: Owner-issued announcement" }, { "source_id": "shc_recap", "title": "Check financing and distributions at the staffing vendor", "publisher": "Vistria Group", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://vistria.com/the-vistria-group-announces-dividend-recapitalization-of-supplemental-health-care/", "reliability_tier": "owner_release", "research_note": "A $100M incremental-debt dividend recap returned about 30% of Vistria's invested capital Limitation: Not a BMC transaction and no evidence BMC approved it" }, { "source_id": "southern_case", "title": "Historical integrity check for a disclosed construction vendor", "publisher": "U.S. Department of Labor OIG/USAO", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.oig.dol.gov/public/Press%20Releases/Massachusetts%20Asbestos%20Abatement%20Company%20And%20Owner%20Sentenced%20For%20Defrauding%20Union%20Benefit%20Funds.pdf", "reliability_tier": "federal_enforcement", "research_note": "Federal sentencing release describes a union-benefit and overtime fraud scheme tied to Southern Middlesex leadership Limitation: Historical vendor conduct; no evidence BMC participated" }, { "source_id": "southern_current", "title": "Match the current vendor identity, address and principals", "publisher": "Southern Middlesex Industries", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.smienvironmental.com/aboutus", "reliability_tier": "vendor_page", "research_note": "Current company page matches the name, address and leadership used for vendor-integrity reconciliation Limitation: Self-published company information" }, { "source_id": "bmc_corporate_partners", "title": "Identify publicly acknowledged corporate relationships and sponsorships", "publisher": "Boston Medical Center", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://development.bmc.org/get-involved/corporate-partnerships/thank-you-to-our-corporate-partners/", "reliability_tier": "employer_page", "research_note": "Lists corporate partners supporting BMC programs Limitation: Sponsorship does not prove a procurement contract" }, { "source_id": "enr_brockton", "title": "Identify BMC Brockton Behavioral Health Center project team and cost", "publisher": "Engineering News-Record", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.enr.com/articles/57580-best-project-health-care-boston-medical-center-brockton-behavioral-health-center", "reliability_tier": "trade_reporting", "research_note": "Describes the approximately $41M project and Southern Middlesex role Limitation: Trade publication; not a complete contract" }, { "source_id": "mcdonald_project", "title": "Identify an electrical trade contractor on BMC capital work", "publisher": "McDonald Electrical Corporation", "publication_date": "", "retrieved_at": "2026-07-12", "url": "https://www.mcdonaldcorp.com/news/mcdonald-electrical-enhances-safety-and-infrastructure-in-boston-medical-centers-menino-lobby-redesign/", "reliability_tier": "vendor_release", "research_note": "Vendor identifies its Menino lobby infrastructure and safety work Limitation: Vendor-authored project description; contract value not disclosed" } ], "descriptiveTrends": [] }