2023-05-11T08:41:18-05:00 2022-06-30 135565207 KPMG LLP 60 SOUTH STREET TWO FINANCIAL CENTER BOSTON MA 02111 990 2021-07-01 900513372 FACULTY PRACTICE FOUNDATION INC & AFFILIATES FACU 6176388000 ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 WILLIAM R CREEVY MD PRESIDENT 6176388000 2023-05-05 1 WILLIAM CREEVY MD 999009999 SMITA BALIGA P01643271 6179881000 2023-05-08 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z WILLIAM R CREEVY MD ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 458441678 1 1 8094 X WWW.BMC.ORG X 1994 MA SEE SCHEDULE O. 39 0 2094 42 384290 0 0 0 406941549 455787499 2855694 2653680 0 0 409797243 458441179 32150 46024 0 0 345032521 381051363 0 0 0 64269638 81023607 409334309 462120994 462934 -3679815 96526141 96334026 29483406 33750283 67042735 62583743 X SEE SCHEDULE O. 0 0 391223796 46024 455787499 THE FACULTY PRACTICE PLANS ("THE PLANS") WERE ESTABLISHED AS NOT-FOR-PROFIT CORPORATIONS OPERATING EXCLUSIVELY FOR THE BENEFIT OF BOSTON MEDICAL CENTER AND BOSTON UNIVERSITY CHOBANIAN & AVEDISIAN SCHOOL OF MEDICINE. THE PLANS' PURPOSE IS TO PROVIDE, COORDINATE AND FACILITATE THE DELIVERY OF PATIENT CARE SERVICES AND TO PROMOTE THE DEVELOPMENT OF AN INTEGRATED SYSTEM OF DELIVERY TO MORE EFFICIENTLY AND EFFECTIVELY MEET THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY THE INSTITUTIONS. THE PLANS PROVIDE AMBULATORY SERVICES RANGING FROM PRIMARY ADULT AND PEDIATRIC CARE TO ADVANCED SPECIALTY CARE; AFFILIATED PHYSICIANS ALSO STAFF THE LARGEST 24 HOUR LEVEL 1 TRAUMA CENTER IN NEW ENGLAND. 391223796 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 2094 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 39 0 1 0 0 0 1 0 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MA X MARY BETH MOLLOY 6174144030 1 BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 X JONATHAN OLSHAKER MD PRS/TRS/CLK/DR -ER (UNTIL 7/21) 50.00 4.00 X X 1036550 0 16925 JENNIFER TSENG MD PRS/TRS/CLRK/DIR - CT, PS, SA, GS 50.00 4.00 X X 992645 0 3746 PAUL TORNETTA MD PRES/TREAS/CLERK/DIR - ORTHO 50.00 X X 973955 0 10681 JAMES HOLSAPPLE MD PRESIDENT/DIRECTOR - NEUROSURG 50.00 X X 940821 0 20439 DAVID COLEMAN MD PRES/TREAS/DIR - EMF 50.00 5.00 X X 828346 0 2429 MINH-TAM TRUONG MD PRES/TREAS/CLERK/DIR - RAD ONC 50.00 X X 698364 0 61251 TOBY CHAI MD PRES/TREAS/CLERK/DIR - UROLOGY 50.00 X X 696271 0 47557 JORGE SOTO MD PRES/DIR - RADIO 50.00 X X 681189 0 30947 STEPHEN CHRISTIANSEN MD PRES/TREAS/CLERK/DIR - EYE 50.00 4.00 X X 685008 0 22662 GREGORY GRILLONE MD PRES/TREAS/DIR - OTO 50.00 4.00 X X 680800 0 23145 RHODA ALANI MD PRES/DIR - DERM 50.00 4.00 X X 699199 0 4416 DAVID GREER MD PRS/TRS/DR-REHAB & PRS/DR-NEURO 50.00 X X 626809 0 30730 RAFAEL ORTEGA MD PRES/TREAS/CLERK/DIR - ANES 50.00 X X 600904 0 24970 ROBERT VINCI MD PRES/CLERK/DIR - CHF 50.00 4.00 X X 572092 0 23527 DAVID HENDERSON MD PRES/TREAS/CLERK/DIR- PSYCH 50.00 4.00 X X 486146 0 35260 AVIVA LEE-PARRITZ MD PRESIDENT/DIRECTOR - OBGYN 50.00 4.00 X X 471977 0 28747 ILSE CASTRO-ARAGON MD CLERK/DIR - RADIO 50.00 X X 397551 0 91712 STEPHEN WILSON MD PRES/TREAS/CLERK/DIR - FAM 50.00 X X 406058 0 26761 CHRISTOPHER ANDRY PHD PRES/TREAS/CLERK/DIR - PATH 50.00 X X 398214 0 32254 JAROSLAW TKACZ MD TREASURER/DIRECTOR - RADIO 50.00 X X 387238 0 32103 RONALD IVERSON MD DIRECTOR - OBGYN 50.00 X 319598 0 61271 MANJU SUBRAMANIAN MD DIRECTOR - EYE 50.00 X 358395 0 20294 PAUL HENDESSI MD DIRECTOR - OBGYN 50.00 X 316380 0 47019 KATHARINE WHITE MD DIRECTOR - OBGYN 50.00 X 321522 0 40488 MIRIAM KOMAROMY MD DIRECTOR - EMF 50.00 X 288820 0 45070 TED CONSTAN TREAS - OB & TREAS/DIR - CHF 50.00 X X 0 242203 52662 MICHELLE LONG MD DIRECTOR - EMF 50.00 X 264554 0 27883 ALLAN WALKEY MD DIRECTOR - EMF 50.00 X 248621 0 43401 VIPUL CHITALIA MD DIRECTOR - EMF 50.00 X 213419 0 68983 ELISABETH WOODHAMS MD DIRECTOR - OBGYN 50.00 X 237131 0 45163 CHRISTIAN ARBELAEZ MD PRES/TREAS/CLK/DIR-ER (AS OF 7/21) 50.00 X X 265570 0 7192 KAREN LASSER MD DIRECTOR - EMF 50.00 X 247377 0 18861 PADMASINI KANDADAI MD DIRECTOR - OBGYN 50.00 X 234598 0 28434 SUSANNAH ROWE MD DIRECTOR - EYE 50.00 X 214452 0 40796 MANISH SAGAR MD DIRECTOR - EMF 50.00 X 227801 0 21740 SAMANTHA KAPLAN MD DIRECTOR - OBGYN 50.00 X 161597 0 66407 ROSHA FORMAN DIRECTOR - OBGYN (AS OF 7/21) 50.00 X 151806 0 38522 MARKUS BOSMAN MD DIRECTOR - EMF 50.00 X 165604 0 17497 JULIE MOTTL-SANTIAGO CNM DIRECTOR - OBGYN (UNTIL 7/21) 50.00 X 145164 0 37003 KETTIE LOUIS DNP DIRECTOR - OBGYN 50.00 X 140889 0 28147 EDWARD FEINBERG MD DIRECTOR - EYE (UNTIL 6/30/22) 50.00 X 7600 0 4800 DAVID BECK SCHEDULE O DISCLOSURE 5.00 49.00 X 0 641355 58909 JACOB PIETER NOORDZIJ MD CLERK - OTO 50.00 X 466492 0 98056 YI-AN HUANG TREASURER - OTO (UNTIL 6/22) 50.00 X 0 268289 51612 SHEILA PHICIL TREAS/CLERK - NEURO (UNTIL 5/22) 50.00 X 0 187038 29044 JAMIE LEVY TREASURER/CLERK - DERM 50.00 X 0 176858 31851 MALLORY DAVIS TREAS/CLERK - NEUROSURG (UNTIL 3/22) 50.00 X 0 127647 27542 CAROL BOUDROT CLERK - OBGYN 50.00 X 0 63717 42845 MATTHEW NIVISON TREAS/CLERK - NEUROSURG (AS OF 4/22) 50.00 X 0 0 0 TONY TANNOURY MD PROFESSOR/PHYSICIAN - ORTHO 50.00 X 1361078 0 106923 XINNING LI MD PHYSICIAN - ORTHO 50.00 X 1388449 0 28475 WILLIAM CREEVY MD PRES - FPF, PROF/PHYS - ORTHO 22.00 32.00 X 1166669 0 28053 CHADI TANNOURY MD PHYSICIAN - ORTHO 50.00 X 1058341 0 27858 NILOO EDWARDS PHYSICIAN - OTO 50.00 X 973133 0 24262 DAVID MCANENY MD FMR PRES/TREAS/CLK/DIR-CT/PS/SA/GS 50.00 4.00 X 667329 0 25092 CHRISTOPHER MANASSEH MD FMR PRES/TREAS/CLERK/DIR - FAM 50.00 4.00 X 428162 0 41827 MARIE SAINT-HILAIRE MD FMR PRES/DIR/TREAS - NEURO 50.00 4.00 X 258743 0 46502 RICHARD BABAYAN MD FMR PRES/TREAS/CLERK/DIR - UROLOGY 50.00 X 139156 0 33740 BRIAN JACK FMR PRES/TREAS/CLERK/DIR - FAM 50.00 4.00 X 135000 0 26779 CARLOS ARELLANO FORMER TREASURER - OTO 50.00 X 0 123805 8845 25833587 1830912 2070110 903 1 1 0 BAY COVE HUMAN SERVICES 66 CANAL STREET 3RD FLOOR BOSTON MA 02114 PHYSICIAN SERVICES 2461439 CHANGE HEALTHCARE LLC 5595 WINDWARD PARKWAY ALPHARETTA GA 30005 BILLING SERVICES 2395238 CHILDREN'S HOSPITAL OF BOSTON 300 LONGWOOD AVENUE BOSTON MA 02115 PHYSICIAN SERVICES 1367903 BU PAYROLL PROCESSING 881 COMMONWEALTH AVE BOSTON MA 02115 PAYROLL SERVICES 1125916 NORTH SUFFOLK MENTAL HEALTH 301 BROADWAY AVE CHELSEA MA 02150 PHYSICIAN SERVICES 798846 19 PATIENT REVENUE 900099 213343196 212958906 384290 INSTITUTIONAL SUPPORT 541380 128658808 128658808 REIMBURSEMENT OF OPERATING EXP 900099 77147983 77147983 CONTRACT & HEALTH CENTER REVENUE 900099 20485792 20485792 CAPITATION REVENUE 900099 394986 394986 15756734 15756734 455787499 2654179 2654179 499 -499 -499 -499 458441179 455403209 384290 2653680 46024 46024 17242683 14682600 2560083 3418781 3122953 295828 296459308 249155442 47303866 63930591 53257514 10673077 25513782 19520570 5993212 65345 53074 12271 1347436 1120803 226633 1763140 1395724 367416 371810 326449 45361 2108525 1832979 275546 15818 12376 3442 8267190 6708597 1558593 615351 487092 128259 5478753 4664402 814351 BAD DEBT EXPENSE 22745867 22745867 MEDICAL & SURGICAL SUPP 6223354 6223354 BU VISITING PROFESSORSH 2500000 2500000 DUES & LICENSES 1987586 1712295 275291 2019650 1655681 363969 462120994 391223796 70897198 0 18206865 11648905 342827 207801 17671344 21142948 12647528 8949477 3373018 3698051 49074210 39404186 7857877 20232135 96526141 96334026 18980681 12598729 4188217 5120885 6314508 16030669 29483406 33750283 X 67042735 62583743 67042735 62583743 96526141 96334026 X -3679815 -8692576 922731 6990668 X 0 1 X 1 0 X X 2 BOSTON MEDICAL CENTER 043314093 3 0 0 0 TRUSTEES OF BOSTON UNIVERSITY 042103547 2 0 615 0 2 615 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 SCHEDULE A, PART IV, SECTION A, LINE 6 IN ADDITION TO PROVIDING SUPPORT TO THEIR SUPPORTED ORGANIZATIONS, THE FACULTY PRACTICE PLANS ALSO PROVIDE SUPPORT TO ORGANIZATIONS THAT ADVANCE THE MISSION OF THE PLANS AND THEIR SUPPORTED ORGANIZATIONS TO PROVIDE, COORDINATE, AND FACILITATE THE DELIVERY OF PATIENT CARE SERVICES. SUPPORT IS INCLUDED ON FORM 990, SCHEDULE I. SCHEDULE A, PART IV, SECTION E, LINE 2A & 2B THE FACULTY PRACTICE PLANS ("THE PLANS") WERE ESTABLISHED AS NOT-FOR-PROFIT CORPORATIONS OPERATING EXCLUSIVELY FOR THE BENEFIT OF BOSTON MEDICAL CENTER AND BOSTON UNIVERSITY CHOBANIAN & AVEDISIAN SCHOOL OF MEDICINE. THE PLANS' PURPOSE IS TO PROVIDE, COORDINATE AND FACILITATE THE DELIVERY OF PATIENT CARE SERVICES AND TO PROMOTE THE DEVELOPMENT OF AN INTEGRATED SYSTEM OF DELIVERY TO MORE EFFICIENTLY AND EFFECTIVELY MEET THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY THE INSTITUTIONS. THE PLANS PROVIDE AMBULATORY SERVICES RANGING FROM PRIMARY ADULT AND PEDIATRIC CARE TO ADVANCE SPECIALTY CARE; AFFILIATED PHYSICIANS ALSO STAFF THE LARGEST 24 HOUR LEVEL 1 TRAUMA CENTER IN NEW ENGLAND. 3578954 2693114 885840 6760242 5712289 1047953 2308332 544074 1764258 3698051 OTHER RECEIVABLES 3949704 DUE FROM AFFILIATES 15585676 OTHER ASSETS 696755 20232135 DUE TO AFFILIATES 13606685 LONG TERM CAPITAL LEASE OBLIGATION 953446 LONG TERMS PORTION DUE TO REL.ORG 1470538 16030669 X PART X, LINE 2: FACULTY PRACTICE FOUNDATION, INC. ("FACULTY") AND ITS AFFILIATED FACULTY PRACTICE PLANS ("PLANS") ARE INCLUDED IN COMBINED FINANCIAL STATEMENTS. THE TEXT OF THE UNCERTAIN TAX POSITIONS FOOTNOTE INCLUDED IN THESE FINANCIAL STATEMENTS IS AS FOLLOWS: THE HEALTH SYSTEM CORPORATION, THE MEDICAL CENTER, WELLSENSE, UDF, ECMF, BUAP, FACULTY AND THE PLANS, BACO, BMCICS, AND BMCIC OF VERMONT ARE ALL NONPROFIT CORPORATIONS THAT HAVE BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HEALTH SYSTEM RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED AS OF SEPTEMBER 30, 2022 AND 2021. THE HEALTH SYSTEM ANNUALLY ASSESSES WHETHER IT MUST RECOGNIZE AN UNRELATED BUSINESS INCOME TAX EXPENSE (UBIT). THE AMOUNTS RECOGNIZED AS UBIT EXPENSE WERE NOT MATERIAL TO THE HEALTH SYSTEM'S CONSOLIDATED OPERATIONS OR CHANGES IN NET ASSETS FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021. 1 SHIPPY FOUNDATION C/O THE CLARK ESTATES INC ONE ROCKEFELLER PLAZA 31 FL NEW YORK NY 10020 204083744 501 (C) (3) 16809 0 GENERAL SUPPORT ORTHOPAEDIC RESEARCH 6300 N RIVER ROAD 700 ROSEMONT IL 60018 366000946 501 (C) (3) 9500 0 GENERAL SUPPORT 2 PART I, LINE 2: FACULTY PRACTICE FOUNDATION, INC. AND AFFILIATES DO NOT DISTRIBUTE RESEARCH OR EDUCATIONAL GRANTS TO OTHER ORGANIZATIONS. THE FUNDS NOTED IN PART II REFLECT DONATIONS MADE BY FACULTY PRACTICE FOUNDATION, INC. AND AFFILIATES TO QUALIFIED 501(C)(3) ORGANIZATIONS. ALL DONATIONS ARE SUBJECT TO REVIEW AND APPROVAL BY THE INDIVIDUAL PRACTICE ADMINISTRATION. X X X 0 1 0 0 0 1 0 1 0 TONY TANNOURY MD PROFESSOR/PHYSICIAN - ORTHO 1358456 0 0 0 2622 0 600 0 106323 0 1468001 0 0 0 XINNING LI MD PHYSICIAN - ORTHO 1387295 0 0 0 1154 0 450 0 28025 0 1416924 0 0 0 WILLIAM CREEVY MD PRES - FPF, PROF/PHYS - ORTHO 956780 0 202650 0 7239 0 600 0 27453 0 1194722 0 0 0 CHADI TANNOURY MD PHYSICIAN - ORTHO 1057201 0 0 0 1140 0 450 0 27408 0 1086199 0 0 0 JONATHAN OLSHAKER MD PRS/TRS/CLK/DR -ER (UNTIL 7/21) 1033583 0 0 0 2967 0 600 0 16325 0 1053475 0 0 0 NILOO EDWARDS PHYSICIAN - OTO 961273 0 5128 0 6732 0 0 0 24262 0 997395 0 0 0 JENNIFER TSENG MD PRS/TRS/CLRK/DIR - CT, PS, SA, GS 990048 0 0 0 2597 0 600 0 3146 0 996391 0 0 0 PAUL TORNETTA MD PRES/TREAS/CLERK/DIR - ORTHO 966677 0 0 0 7278 0 600 0 10081 0 984636 0 0 0 JAMES HOLSAPPLE MD PRESIDENT/DIRECTOR - NEUROSURG 933780 0 0 0 7041 0 600 0 19839 0 961260 0 0 0 DAVID COLEMAN MD PRES/TREAS/DIR - EMF 820438 0 0 0 7908 0 600 0 1829 0 830775 0 0 0 MINH-TAM TRUONG MD PRES/TREAS/CLERK/DIR - RAD ONC 673041 0 0 0 25323 0 550 0 60701 0 759615 0 0 0 TOBY CHAI MD PRES/TREAS/CLERK/DIR - UROLOGY 690116 0 0 0 6155 0 17400 0 30157 0 743828 0 0 0 JORGE SOTO MD PRES/DIR - RADIO 677872 0 0 0 3317 0 600 0 30347 0 712136 0 0 0 STEPHEN CHRISTIANSEN MD PRES/TREAS/CLERK/DIR - EYE 676562 0 0 0 8446 0 600 0 22062 0 707670 0 0 0 GREGORY GRILLONE MD PRES/TREAS/DIR - OTO 674796 0 0 0 6004 0 600 0 22545 0 703945 0 0 0 RHODA ALANI MD PRES/DIR - DERM 695860 0 0 0 3339 0 600 0 3816 0 703615 0 0 0 DAVID BECK SCHEDULE O DISCLOSURE 0 424344 0 155488 0 61523 0 20300 0 38609 0 700264 0 0 DAVID MCANENY MD FMR PRES/TREAS/CLK/DIR-CT/PS/SA/GS 591906 0 71067 0 4356 0 2379 0 22713 0 692421 0 0 0 DAVID GREER MD PRS/TRS/DR-REHAB & PRS/DR-NEURO 623811 0 0 0 2998 0 600 0 30130 0 657539 0 0 0 RAFAEL ORTEGA MD PRES/TREAS/CLERK/DIR - ANES 595722 0 0 0 5182 0 2400 0 22570 0 625874 0 0 0 ROBERT VINCI MD PRES/CLERK/DIR - CHF 567158 0 0 0 4934 0 1310 0 22217 0 595619 0 0 0 JACOB PIETER NOORDZIJ MD CLERK - OTO 389362 0 68767 0 8363 0 12285 0 85771 0 564548 0 0 0 DAVID HENDERSON MD PRES/TREAS/CLERK/DIR- PSYCH 482592 0 0 0 3554 0 6992 0 28268 0 521406 0 0 0 AVIVA LEE-PARRITZ MD PRESIDENT/DIRECTOR - OBGYN 468643 0 0 0 3334 0 9389 0 19358 0 500724 0 0 0 ILSE CASTRO-ARAGON MD CLERK/DIR - RADIO 396516 0 0 0 1035 0 12285 0 79427 0 489263 0 0 0 CHRISTOPHER MANASSEH MD FMR PRES/TREAS/CLERK/DIR - FAM 404567 0 22680 0 915 0 12099 0 29728 0 469989 0 0 0 STEPHEN WILSON MD PRES/TREAS/CLERK/DIR - FAM 393188 0 0 0 12870 0 0 0 26761 0 432819 0 0 0 CHRISTOPHER ANDRY PHD PRES/TREAS/CLERK/DIR - PATH 395351 0 0 0 2863 0 13200 0 19054 0 430468 0 0 0 JAROSLAW TKACZ MD TREASURER/DIRECTOR - RADIO 386295 0 0 0 943 0 12833 0 19270 0 419341 0 0 0 RONALD IVERSON MD DIRECTOR - OBGYN 318182 0 0 0 1416 0 17004 0 44267 0 380869 0 0 0 MANJU SUBRAMANIAN MD DIRECTOR - EYE 328926 0 28954 0 515 0 13782 0 6512 0 378689 0 0 0 PAUL HENDESSI MD DIRECTOR - OBGYN 315498 0 0 0 882 0 17100 0 29919 0 363399 0 0 0 KATHARINE WHITE MD DIRECTOR - OBGYN 321028 0 0 0 494 0 15675 0 24813 0 362010 0 0 0 MIRIAM KOMAROMY MD DIRECTOR - EMF 273873 0 1500 0 13447 0 17160 0 27910 0 333890 0 0 0 YI-AN HUANG TREASURER - OTO (UNTIL 6/22) 0 230804 0 28050 0 9435 0 12343 0 39269 0 319901 0 0 MARIE SAINT-HILAIRE MD FMR PRES/DIR/TREAS - NEURO 257016 0 0 0 1727 0 16080 0 30422 0 305245 0 0 0 TED CONSTAN TREAS - OB & TREAS/DIR - CHF 0 218155 0 17475 0 6573 0 11650 0 41012 0 294865 0 0 MICHELLE LONG MD DIRECTOR - EMF 261822 0 2500 0 232 0 12675 0 15208 0 292437 0 0 0 ALLAN WALKEY MD DIRECTOR - EMF 241061 0 7198 0 362 0 14630 0 28771 0 292022 0 0 0 VIPUL CHITALIA MD DIRECTOR - EMF 207954 0 5000 0 465 0 13329 0 55654 0 282402 0 0 0 ELISABETH WOODHAMS MD DIRECTOR - OBGYN 236881 0 0 0 250 0 12165 0 32998 0 282294 0 0 0 CHRISTIAN ARBELAEZ MD PRES/TREAS/CLK/DIR-ER (AS OF 7/21) 252348 0 0 0 13222 0 0 0 7192 0 272762 0 0 0 KAREN LASSER MD DIRECTOR - EMF 245687 0 1141 0 549 0 15528 0 3333 0 266238 0 0 0 PADMASINI KANDADAI MD DIRECTOR - OBGYN 234431 0 0 0 167 0 10878 0 17556 0 263032 0 0 0 SUSANNAH ROWE MD DIRECTOR - EYE 208050 0 5370 0 1032 0 13320 0 27476 0 255248 0 0 0 MANISH SAGAR MD DIRECTOR - EMF 223199 0 4111 0 491 0 14692 0 7048 0 249541 0 0 0 SAMANTHA KAPLAN MD DIRECTOR - OBGYN 161282 0 0 0 315 0 10243 0 56164 0 228004 0 0 0 SHEILA PHICIL TREAS/CLERK - NEURO (UNTIL 5/22) 0 172015 0 9180 0 5843 0 5519 0 23525 0 216082 0 0 JAMIE LEVY TREASURER/CLERK - DERM 0 148104 0 13335 0 15419 0 10922 0 20929 0 208709 0 0 ROSHA FORMAN DIRECTOR - OBGYN (AS OF 7/21) 151688 0 0 0 118 0 6884 0 31638 0 190328 0 0 0 MARKUS BOSMAN MD DIRECTOR - EMF 163963 0 1500 0 141 0 7658 0 9839 0 183101 0 0 0 JULIE MOTTL-SANTIAGO CNM DIRECTOR - OBGYN (UNTIL 7/21) 144537 0 0 0 627 0 9144 0 27859 0 182167 0 0 0 RICHARD BABAYAN MD FMR PRES/TREAS/CLERK/DIR - UROLOGY 139156 0 0 0 0 0 9000 0 24740 0 172896 0 0 0 KETTIE LOUIS DNP DIRECTOR - OBGYN 140165 0 0 0 724 0 9332 0 18815 0 169036 0 0 0 BRIAN JACK FMR PRES/TREAS/CLERK/DIR - FAM 134380 0 0 0 620 0 8077 0 18702 0 161779 0 0 0 MALLORY DAVIS TREAS/CLERK - NEUROSURG (UNTIL 3/22) 0 120643 0 0 0 7004 0 3955 0 23587 0 155189 0 0 CARLOS ARELLANO FORMER TREASURER - OTO 0 116992 0 0 0 6813 0 4732 0 4113 0 132650 0 0 PART I, LINE 4B BOSTON MEDICAL CENTER PROVIDES A SUPPLEMENTAL EXECTUTIVE RETIREMENT PLAN TO CERTAIN EXECUTIVES. AMOUNTS ARE CREDITED TO PARTICIPANTS' ACCOUNTS EACH YEAR. PLAN AMOUNTS ARE SUBJECT TO FORFEITURE AND PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET, AS OUTLINED IN THE PLAN AGREEMENT. BOSTON MEDICAL CENTER MAINTAINS AN EXECUTIVE BENEFIT PLAN WHICH OFFERS PARTICIPATING EXECUTIVES THE OPTION OF ANNUALLY ALLOCATING BENEFIT DOLLARS TO A SUPPLEMENTAL RETIREMENT/PRE-TAX SAVINGS ACCOUNT. AMOUNTS VEST ON SPECIFIED DATES BASED ON CONTINUED EMPLOYMENT BUT NO LATER THAN THE EXECUTIVE'S 62ND BIRTHDAY. AMOUNTS ACCRUED IN THE PLAN ARE REPORTED IN SCHEDULE J, PART II, COLUMN C. BOSTON MEDICAL CENTER PROVIDED A 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN TO DAVID BECK, SENIOR VICE PRESIDENT, CHIEF LEGAL COUNSEL, AND CLERK OF BOSTON MEDICAL CENTER. DAVID BECK REACHED THE PLAN RETIREMENT AGE IN 2019 AND VESTED 100% IN THE PLAN. IN ADDITION, PURSUANT TO THE TERMS OF THE PLAN, ONCE THE PLAN PARTICIPANT REACHES THE PLAN RETIREMENT AGE, ALL FUTURE CONTRIBUTIONS ARE MADE IN CASH. ACCORDINGLY, THE AMOUNT OF $51,600 WAS PAID TO DAVID BECK IN CASH IN 2021. PART I, LINE 6 EMPLOYEES OF THE FACULTY PRACTICE PLANS ARE SUBJECT TO THE PLANS' INDIVIDUAL COMPENSATION POLICIES OR THE COMPENSATION POLICIES OF BOSTON MEDICAL CENTER. BASED ON THESE POLICIES, EMPLOYEES MAY RECEIVE COMPENSATION BASED ON NET EARNINGS OF THE DEPARTMENT. PART I, LINE 7 EMPLOYEES OF THE FACULTY PRACTICE PLANS ARE SUBJECT TO THE PLANS' INDIVIDUAL COMPENSATION POLICIES OR THE COMPENSATION POLICIES OF BOSTON MEDICAL CENTER. BASED ON THESE POLICIES, PHYSICIANS MAY RECEIVE NON-FIXED BONUS PAYMENTS REPORTED ON SCHEDULE J, PART II, COLUMN B(II). LISTED INDIVIDUALS LISTED INDIVIDUALS RECEIVE COMPENSATION FOR THE SERVICES THEY PROVIDE AS EMPLOYEES. THEY RECEIVE NO COMPENSATION FOR THEIR ROLES AS DIRECTORS, OFFICERS, OR FORMER OFFICERS. FORM 990, PART I, LINE 1 & PART III, LINES 1 THE FACULTY PRACTICE PLANS ("THE PLANS") WERE ESTABLISHED AS NOT-FOR-PROFIT CORPORATIONS OPERATING EXCLUSIVELY FOR THE BENEFIT OF BOSTON MEDICAL CENTER AND BOSTON UNIVERSITY CHOBANIAN & AVEDISIAN SCHOOL OF MEDICINE. THE PLANS' PURPOSE IS TO PROVIDE, COORDINATE AND FACILITATE THE DELIVERY OF PATIENT CARE SERVICES AND TO PROMOTE THE DEVELOPMENT OF AN INTEGRATED SYSTEM OF DELIVERY TO MORE EFFICIENTLY AND EFFECTIVELY MEET THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY THE INSTITUTIONS. THE PLANS PROVIDE AMBULATORY SERVICES RANGING FROM PRIMARY ADULT AND PEDIATRIC CARE TO ADVANCED SPECIALTY CARE; AFFILIATED PHYSICIANS ALSO STAFF THE LARGEST 24 HOUR LEVEL 1 TRAUMA CENTER IN NEW ENGLAND. FORM 990, PART VI, SECTION A, LINE 2 ALL OFFICERS AND DIRECTORS ARE EMPLOYEES OF EITHER THE INDIVIDUAL PRACTICE PLAN, BOSTON UNIVERSITY OR BOSTON MEDICAL CENTER, RELATED ORGANIZATIONS. CERTAIN OFFICERS AND DIRECTORS OF THE PRACTICE PLANS ALSO SERVE AS OFFICERS AND TRUSTEES OF BOSTON MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 6 WITH THE EXCEPTION OF THOSE LISTED BELOW, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS FACULTY PRACTICE FOUNDATION, INC. BU SURGICAL ASSOCIATES IS THE SOLE CORPORATE MEMBER OF THE FOLLOWING: - BOSTON UNIVERSITY CARDIAC AND THORACIC SURGICAL FOUNDATION, INC. - BOSTON UNIVERSITY GENERAL SURGICAL ASSOCIATES, INC. - BOSTON UNIVERSITY NEUROSURGICAL ASSOCIATES, INC. - BOSTON UNIVERSITY ORTHOPAEDIC SURGICAL ASSOCIATES, INC. - BOSTON UNIVERSITY PLASTIC SURGERY ASSOCIATES, INC. - BOSTON UNIVERSITY MEDICAL CENTER UROLOGISTS, INC. - BUMC OTOLARYNGOLOGIC FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN ACTIONS MUST BE APPROVED BY THE ORGANIZATION'S SOLE CORPORATE MEMBER, AS SET FORTH IN THE BYLAWS, INCLUDING ADOPTION OF THE BUDGET, ANY MERGER, CONSOLIDATION, LIQUIDATION OR DISSOLUTION, ANY CAPITAL TRANSACTION, AND INCURRENCE OF DEBT. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO THE FILING OF THE FORM 990 WITH THE IRS, THE FORM 990 WAS PREPARED BY OUR OUTSIDE TAX CONSULTANTS AND REVIEWED BY INTERNAL MANAGEMENT. THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOSTON MEDICAL CENTER BOARD OF TRUSTEES THEN REVIEWED THE RETURN. EACH MEMBER OF THE BOARD OF EACH PLAN WAS PROVIDED A COPY OF THE FINAL FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST QUESTIONNAIRES FOR THE FISCAL YEAR ENDING JUNE 30, 2022 WERE DISTRIBUTED ON 3/1/2023 BY THE COMPLIANCE DEPARTMENT. THE CHIEF COMPLIANCE OFFICER OR HIS DESIGNEE QUERIES TRUSTEES, OFFICERS, AND DIRECTORS ON AT LEAST AN ANNUAL BASIS REGARDING RELATIONSHIPS THAT MAY CREATE POTENTIAL CONFLICTS OF INTEREST. THE CHIEF COMPLIANCE OFFICER OR HIS DESIGNEE REVIEWS ALL DISCLOSURES AND DETERMINES WHETHER THERE ARE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE CHIEF COMPLIANCE OFFICER ADVISES THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION ACCORDINGLY. FORM 990, PART VI, SECTION B, LINE 15 A COMMITTEE COMPOSED OF THE PRESIDENT AND CEO OF BOSTON MEDICAL CENTER AND THE DEAN OF BOSTON UNIVERSITY CHOBANIAN & AVEDISIAN SCHOOL OF MEDICINE, THE FOUNDATION'S CORPORATE MEMBERS, APPROVES THE COMPENSATION FOR CERTAIN PHYSICIAN EXECUTIVES. A MEETING OF THE COMMITTEE WAS HELD TO REVIEW AND APPROVE THE FY2022 PROPOSED COMPENSATION FOR THE PHYSICIAN EXECUTIVES SERVING AS PRESIDENTS OF THE PLANS. FOR FY2022 THE SALARY OF EACH OF THE PHYSICIAN EXECUTIVES UNDER CONSIDERATION WAS PROVIDED TO THE COMMITTEE. THE COMMITTEE EVALUATED AND RELIED UPON COMPARABLE DATA IN MAKING ITS DECISION. THE COMPARABLE DATA CONSISTED OF COMPENSATION SURVEY INFORMATION FROM THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES FOR EACH SPECIALTY WHERE AVAILABLE, LISTING BOTH THE FIFTIETH AND SEVENTY-FIFTH SALARY PERCENTILES. THE PROPOSED COMPENSATION AS SUBMITTED OR AMENDED BY THE COMMITTEE WAS VOTED UPON BY THE COMMITTEE. THE COMMITTEE'S ASSESSMENT OF THESE CONSIDERATIONS IS CONTAINED IN THE OFFICIAL MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE PLANS DO NOT MAKE THEIR GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE THROUGH THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE. FORM 990, PART VII, SECTION A SHARED SERVICE AGREEMENT THE PLANS ARE AFFILIATED WITH BOSTON MEDICAL CENTER ("BMC") AND BOSTON UNIVERSITY CHOBANIAN & AVEDISIAN SCHOOL OF MEDICINE ("CHOBANIAN & AVEDISIAN SCHOOL"). THE PLANS EACH ENTERED INTO A COMMON PAYMASTER AGREEMENT WITH BMC AND THE TRUSTEES OF BOSTON UNIVERSITY ("BU"). UNDER THE TERMS OF THEIR PHYSICIAN PRACTICE AGREEMENTS, FACULTY PHYSICIANS AND PRACTITIONERS ("FACULTY MEMBERS") ARE EMPLOYED BY THE INDIVIDUAL PLANS. THE FACULTY MEMBERS SERVE THE BENEFIT OF BOTH BMC (BY PROVIDING CLINICAL SERVICES) AND CHOBANIAN & AVEDISIAN SCHOOL (BY SERVING AS FACULTY MEMBERS OF CHOBANIAN & AVEDISIAN SCHOOL). EACH PLAN, WITH RESPECT TO EACH FACULTY MEMBER THAT THE PLAN EMPLOYS, PAYS BU A PERCENTAGE OF THE FACULTY MEMBER'S SALARY AND REIMBURSEMENT FOR FRINGE BENEFITS AND RELATED PAYMENT FEES. BOSTON UNIVERSITY, AS COMMON PAYMASTER, THEN MAKES SALARY PAYMENTS AND PROVIDES BENEFITS TO FACULTY MEMBERS. THE PLANS ALSO PAY FOR A PORTION OF ADMINISTRATIVE SALARIES AND FRINGE BENEFITS FOR NONPHYSICIAN EMPLOYEES OF BMC, WHO PROVIDE SERVICES TO THEM. FORM 990, PART VII, LINE 17 DAVID BECK IS ASSISTANT CLERK FOR ALL REPORTING ENTITIES EXCEPT EVANS MEDICAL FOUNDATION AND BOSTON REHABILITATION MEDICINE ASSOCIATES, INC. FOR EVANS AND REHAB, HE SERVES AS CLERK. FOR FACULTY PRACTICE FOUNDATION, INC. HE IS A FORMER ASSISTANT CLERK. FORM 990, PART XI, LINE 9: NET ASSET TRANSFER 6,990,668. BOSTON MEDICAL CENTER ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 043314093 HEALTHCARE MA 501(C)(3) LINE 3 N/A 0 TRUSTEES OF BOSTON UNIVERSITY ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02115 042103547 EDUCATION MA 501(C)(3) LINE 2 N/A 0 FACULTY PRACTICE FOUNDATION INC ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 043289381 HEALTHCARE MA 501(C)(3) 12B, TYPE 1 N/A 0 0 1 0 0 1 0 0 0 0 0 1 0 0 1 1 1 1 1 1